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Les problèmes de multirésistance concernant de nombreuses souches bactériennes sont une réelle préoccupation de santé publique à l'heure actuelle. Plus particulièrement, la problématique de la tuberculose multirésistante (tuberculose résistant à la fois à l'isoniazide et à la rifampicine) semble un sujet pour lequel le pharmacien devrait être sensibilisé. En effet, les deux causes majeures de multirésistance dans le cas de la tuberculose sont soit un problème de diagnostic soit un problème quant à la gestion du traitement. Le pharmacien- étant au cœur de l'élaboration et du suivi de ce traitement, il semble logique de l'inclure dans l'équipe de gestion de cette résistance. Ce mémoire a donc deux objectifs précis. Tout d'abord, réaliser un travail sur l'état actuel des connaissances concernant la tuberculose multirésistante sur un plan épidémiologique, de diagnostic et de stratégie de traitement. Ensuite, inclure dans ce travail une étude réalisée auprès des pharmaciens d'officine afin de déterminer ce que ces derniers mettent en œuvre pour augmenter la compliance des patients pour le suivi de leur traitement. Au vu des résultats de cette étude, ce travail se clôture par l'élaboration d'une fiche de soutien destiné au pharmacien d'officine afin d'aider ce dernier pour la gestion des patients tuberculeux et in fine, d'essayer de diminuer l'émergence de cas de multirésistance. For many bacterial strains multi-resistance problems arte a real public health concern at present. In particular, the problem of multi-drug resistant tuberculosis (tuberculosis resistant to both isoniazid and rifampicin) seems a subject for which the pharmacist should be aware. Indeed, the two major causes of multidrug resistance in the case of tuberculosis are either a diagnostic problem or a problem in the management of treatment. The pharmacist is at the heart of the development and monitoring of this treatment, it seems logical to include him in the strength of the management team. This thesis thus has two specific goals. First, perform work on the current state of the art regarding multi-resistant tuberculosis on epidemiological, diagnostic and treatment. Secondly include in this work a study of pharmacists to determine what they are implementing to increase patient compliance in monitoring their treatment. Give the results of this study, this work ends with the development of a support sheet for the pharmacist to assist it in the management of TB patients and, ultimately, to try to reduce the emergence of cases of multi-resistance.

Tuberculosis, Multidrug-Resistant

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Multidrug-resistant tuberculosis --- Treatment.

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Multidrug-resistant tuberculosis --- Multidrug-resistant tuberculosis --- Treatment. --- Prevention --- Government policy.

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"An estimated 8.8 million people fell ill with tuberculosis (TB) in 2010 and 1.4 million died from the disease. Although antibiotics to treat TB were developed in the 1950s and are effective against a majority of TB cases, resistance to these antibiotics has emerged over the years, resulting in the growing spread of multidrug-resistant (MDR) TB. Due to challenges in timely and accurate diagnosis of drug-resistant TB, length and tolerability of treatment regimens, and expense of second-line anti-TB drugs, effectively controlling the disease requires complex public health interventions. The IOM Forum on Drug Discovery, Development, and Translation held three international workshops to gather information from local experts around the world on the threat of drug resistant TB and how the challenges it presents can be met. Workshops were held in South Africa and Russia in 2010. The third workshop was held April 18-19, 2011, in New Delhi, India, in collaboration with the Indian National Science Academy and the Indian Council of Medical Research. The aim of the workshop was to highlight key challenges to controlling the spread of drug-resistant strains of TB in India and to discuss strategies for advancing and integrating local and international efforts to prevent and treat drug-resistant TB. This document summarizes the workshop."--Publisher's description.

Multidrug-resistant tuberculosis. --- Antitubercular agents.

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Multidrug-resistant tuberculosis --- Treatment --- Prevention.