Treatment outcome with a short multidrug-resistant tuberculosis regimen in nine African countries
| Autor: | S Hassane, M. Gninafon, A Bakayoko, K G Koura, J Noeske, Hans L. Rieder, Daniela Maria Cirillo, Mathieu Ouédraogo, A. Van Deun, Christopher Kuaban, V Fikouma, Z Kashongwe, Arnaud Trébucq, Alberto Piubello, V Schwoebel, François Ciza, B Souleymane, M Gasana |
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| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Tuberculosis Time Factors Adolescent Antitubercular Agents HIV Infections Clofazimine 03 medical and health sciences Young Adult 0302 clinical medicine Moxifloxacin Internal medicine Drug Resistance Bacterial Tuberculosis Multidrug-Resistant medicine Humans 030212 general & internal medicine Prospective Studies Treatment Failure Hearing Loss Ethambutol Aged business.industry Pyrazinamide Middle Aged medicine.disease Surgery Regimen Infectious Diseases Treatment Outcome 030228 respiratory system Prothionamide Africa Ethionamide Female business medicine.drug |
| Zdroj: | The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 22(1) |
| ISSN: | 1815-7920 |
| Popis: | Setting Nine countries in West and Central Africa. Objective To assess outcomes and adverse drug events of a standardised 9-month treatment regimen for multidrug-resistant tuberculosis (MDR-TB) among patients never previously treated with second-line drugs. Design Prospective observational study of MDR-TB patients treated with a standardised 9-month regimen including moxifloxacin, clofazimine, ethambutol (EMB) and pyrazinamide (PZA) throughout, supplemented by kanamycin, prothionamide and high-dose isoniazid during an intensive phase of a minimum of 4 to a maximum of 6 months. Results Among the 1006 MDR-TB patients included in the study, 200 (19.9%) were infected with the human immunodeficiency virus (HIV). Outcomes were as follows: 728 (72.4%) cured, 93 (9.2%) treatment completed (81.6% success), 59 (5.9%) failures, 78 (7.8%) deaths, 48 (4.8%) lost to follow-up. The proportion of deaths was much higher among HIV-infected patients (19.0% vs. 5.0%). Treatment success did not differ by HIV status among survivors. Fluoroquinolone resistance was the main cause of failure, while resistance to PZA, ethionamide or EMB did not influence bacteriological outcome. The most important adverse drug event was hearing impairment (11.4% severe deterioration after 4 months). Conclusions The study results support the use of the short regimen recently recommended by the World Health Organization. Its high level of success even among HIV-positive patients promises substantial improvements in TB control. |
| Databáze: | OpenAIRE |
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