| Autor: |
Gina Gualano, Katerina Manika, Lia D'Ambrosio, Jerker Jonsson, Lina Davies Forsman, Sergey Borisov, Federica Toscanini, Antonio Spanevello, Tatsiana Sanukevich, Jan-Willem C. Alffenaar, Martin Enwerem, Giovanni Sotgiu, Julia Amaranta Garcia-Fuertes, Paul Douglas, Carlos Robalo Cordeiro, Suzette Oelofse, Veronica White, Alimuddin Zumla, Mohammed Fadul, Giovanni Battista Migliori, Judith Bruchfeld, Simon Tiberi, Evgeny Belilowski, Alex Filippov, Alena Skrahina, Marie-Christine Payen, Margareth Pretti Dalcolmo, Apostolos Papavasileiou, Aliasgar Esmail, Onno W. Akkerman, Andrey Maryandyshev, Jorge Lazaro Teran Troya, Shashank Ganatra, Justin T Denholm, Rodolfo Romero Leyet, Jillian S.Y. Lau, Keertan Dheda, José-María García-García, Barbara Lazaro Mastrapa, Alena Aleksa, Fabrizio Palmieri, Luigi Codecasa, Jai B Mullerpattan, Mina Gaga, Sonam Topgyal, Tsetan Dorji Sadutshang, Isabel Carpena Martinez, Pietro Viggiani, Emanuele Pontali, Zarir F Udwadia, Antonella Papalia, Varvara Solodovnikova, Raquel Duarte, Domingo Palmero, Martina Ortelli, Janina Artsukevich, Selene Manga, Adrian R Tramontana, Heinke Kunst, Rohit Amale, Jose A. Caminero, Rosella Centis, Pablo González Montaner |
| Rok vydání: |
2017 |
| Předmět: |
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| Zdroj: |
Tuberculosis. |
| Popis: |
Introduction: Well designed studies on BQ used programmatically to treat M/XDR tuberculosis (TB) are lacking. The aim of this study is to evaluate effectiveness and safety of BQ in a large retrospective, observational study conducted in 25 centres in 15 countries on 5 continents. Methods: Bacteriological conversion rates, treatment outcomes (WHO definitions) and adverse events observed in confirmed MDR-TB BQ-treated patients were analysed. Results: 428 MDR-TB cases (representing 10-100% of all national cases treated from January 2007 to March 2015) were enrolled: median age (IQR): 35 years (27-44); 61.3% males; 22.1% HIV-positive; 45.6% XDR-TB. The median (IQR) number of hospital admission days was 179 (92-280) and exposure to BQ 168 days (86-180). 5 cases received both BQ and delamanid. Treatment regimens included linezolid (82.0% of cases), moxifloxacin (53.7%) and carbapenems (15.7%). Sputum smear (SS) and culture (C) conversion rates were at 30 days 63.6 and 30.1%; at 60 days 81.1 and 56.7%; at 90 days 85.5 and 80.5% and the end of treatment 90.0 and 91.8%, respectively. The time to SS and C conversion was 34 (30-60) and 60 (33-90) days. Out of 246 cases completing treatment, 71.1% achieved success (62.2% cured; 8.9% treatment completed), 13.4% died, 8.1% failed and 7.3% were lost to follow-up. 51/428 (11.2%) cases interrupted BQ for any reason, 23/428 permanently (5.4%; 16/428 -1.4% - because of cardiologic disorders). Conclusions: The results of this study, the largest ever done, indicate that BQ-containing regimens used at the programmatic level achieve satisfactory outcomes and bacteriological conversion rates even with a significant proportion of XDR-TB cases. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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