Salvage Regimen

To salvage literally means “to prevent being ruined, destroyed or lost”. Salvage Therapy is the common term used for a treatment given after an ailment does not respond to standard treatment. The most common diseases that require salvage therapy are HIV and various tumors. Salvage therapy drugs or drug combinations are called "Salvage Regiment". Its obvious that in general, Salvage Regiment has much more severe side effects than the standard line of therapy.

The term was recently in news in context with TDR TB. Six months back, there were reports of ‘totally drug resistant tuberculosis (TDR TB)’ from Mumbai. TDR TB as a bacterial strain that did not respond to all first-line (isoniazide, rifampicin, ethambutol, pyrazinamide and streptomycin) and second-line (ofloxacin, moxifloxacin, kanamycin, amikacin, capreomycin, paraaminosalicylic acid and ethionamide) drugs.

Recently, the experts have come up with positive response of the “salvage regimen” for the disease. It comprises double dose isoniazid, linezolid, meropenem, clofazamine, etc. Some of these drugs are toxic tertiary antibiotics and others are usually used for diseases other than TB, but in a five-six drug combination, these were found to be helpful in taming the extra drug-resistant variety of the disease Doctors claim salvage regimen is patient-specific. The “salvage regimen” comprises all other medicines/surgical options left open.

White Plague

White Plague is a term used for TB in those times, when TB was incurable, i.e. during the 19th and early 20th century.  In context with the TDR TB, WHO had expressed apprehensions for return of White Plague.