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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Resistance to fluoroquinolones and second-line injectable drugs: Impact on multidrug-resistant TB outcomes
European Respiratory Journal, Volume 42, No. 1, Year 2013
Notification
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Description
A meta-analysis for response to treatment was undertaken using individual data of multidrug-resistant tuberculosis (MDR-TB) (resistance to isoniazid and rifampicin) patients from 26 centres. The analysis assessed the impact of additional resistance to fluoroquinolones and/or second-line injectable drugs on treatment outcome. Compared with treatment failure, relapse and death, treatment success was higher in MDR-TB patients infected with strains without additional resistance (n=4763; 64%, 95%CI 57-72%) or with resistance to second-line injectable drugs only (n=1130; 56%, 95%CI 45-66%), than in those having resistance to fluoroquinolones alone (n=426; 48%, 95%CI 36-60%) or to fluoroquinolones plus second-line injectable drugs (extensively drug resistant (XDR)-TB) (n=405; 40%, 95%CI 27-53%). In XDR-TB patients, treatment success was highest if at least six drugs were used in the intensive phase (adjusted OR 4.9, 95%CI 1.4-16.6; reference fewer than three drugs) and four in the continuation phase (OR 6.1, 95%CI 1.4-26.3). The odds of success in XDR-TB patients was maximised when the intensive phase reached 6.6-9.0 months duration and the total duration of treatment 20.1-25.0 months. In XDR-TB patients, regimens containing more drugs than those recommended in MDR-TB but given for a similar duration were associated with the highest odds of success. All data were from observational studies and methodologies varied between centres, therefore, the bias may be substantial. Better quality evidence is needed to optimise regimens. Copyright © ERS 2013.
Authors & Co-Authors
Falzon, Dennis
Switzerland, Geneva
Organisation Mondiale de la Santé
Gandhi, Neel R.
United States, New York
Albert Einstein College of Medicine of Yeshiva University
Migliori, Giovanni Battista
United States, Boston
Harvard Medical School
Italy
Tradate
Sotgiu, Giovanni
United States, Davis
University of California, Davis
Cox, Helen S.
Switzerland, Geneva
Organisation Mondiale de la Santé
Holtz, Timothy H.
Italy, Sassari
Università Degli Studi Di Sassari
Hollm-Delgado, Maria Graciela
Switzerland, Geneva
Medecins Sans Frontieres
Keshavjee, Salmaan A.
United States, Atlanta
Centers for Disease Control and Prevention
DeRiemer, Kathryn
Germany, Borstel
Research Center Borstel
Centis, Rosella
United States, Boston
Harvard Medical School
Italy
Tradate
D'Ambrosio, Lia
United States, Boston
Harvard Medical School
Italy
Tradate
Lange, Christoph G.
Canada, Montreal
Université Mcgill
Bauer, Melissa
Switzerland, Geneva
Medecins Sans Frontieres
Canada, Montreal
Mcgill University Health Centre, Montreal Chest Institute
Richard (Dick), Menzies
Switzerland, Geneva
Medecins Sans Frontieres
Ahuja, Shama Desai
United States, Long Island City
Long Island City
Ashkin, David
United States
Lantana
Avendaño, Mónica Arboleya
Unknown Affiliation
Banerjee, Ritu
Unknown Affiliation
Becerra, Mercedes C.
Unknown Affiliation
Benedetti, Andrea L.
Unknown Affiliation
Burgos, Marcos V.
Unknown Affiliation
Chan, Edward D.
Unknown Affiliation
Chiang, Chenyuan
Taiwan, Taipei
Taipei City Government
Cobelens, Frank G.J.
Unknown Affiliation
Cox, Helen
Unknown Affiliation
de Lange, Wiel C.M.
Unknown Affiliation
Enarson, Donald A.
Unknown Affiliation
Flanagan, Katie L.
Gambia
Fajara
Flood, Jennifer M.
Unknown Affiliation
Garcia-Garcia, M. L.
Mexico
Cuernavaca
Granich, Reuben M.
Unknown Affiliation
Hopewell, Philip C.
Unknown Affiliation
Iseman, Michael D.
Unknown Affiliation
Jarlsberg, Leah G.
Unknown Affiliation
Kim, Hye-ryoun
Unknown Affiliation
Koh, Wonjung
Unknown Affiliation
Lancaster, Joey L.
Unknown Affiliation
Lange, Christoph
Unknown Affiliation
Leimane, Vaira
Latvia
Upeslejas
Leung, Chichiu
Unknown Affiliation
Li, Jiehui
Unknown Affiliation
Mitnick, Carole Diane
Unknown Affiliation
Narita, Masahiro
Unknown Affiliation
Nathanson, Eva
United Kingdom, London
London
Odendaal, Ronel
United Kingdom, London
London
O'Riordan, Philly
United Kingdom, London
London
Pai, Madhukar
Unknown Affiliation
Palmero, Domingo Juan
Unknown Affiliation
Park, Seungkyu
Unknown Affiliation
Pasvol, Geoffrey
United Kingdom, London
London
Pena, J. M.
Unknown Affiliation
Pérez-Guzmán, Carlos
Mexico
Aguascalientes
Ponce-de-Leon, Alfredo
Mexico, Zaragoza
Mexico City
Quelapio, Maria Imelda D.
Unknown Affiliation
Quy, Hoang Thi W.
Latvia
Upeslejas
Riekstiņa, Vieja
Latvia
Upeslejas
Robert, Jérome
Unknown Affiliation
Royce, Sarah E.
Unknown Affiliation
Salim, Md Abdul Hamid
Unknown Affiliation
Schaaf, Hendrik Simon
Unknown Affiliation
Seung, Kwonjune J.
Unknown Affiliation
Shah, Lena
Unknown Affiliation
Shean, Karen P.
Unknown Affiliation
Shim, Tae-sun
Unknown Affiliation
Shin, Sonya Sunhi
Unknown Affiliation
Shiraishi, Yuji
Unknown Affiliation
Sifuentes-Osornio, José
Mexico, Zaragoza
Mexico City
Strand, Matthew J.
Unknown Affiliation
Sung, S. W.
Unknown Affiliation
Tabarsi, Payam
Unknown Affiliation
Tupasi, Thelma E.
Unknown Affiliation
Vargas, Mario H.
Mexico, Zaragoza
Mexico City
van Altena, Richard
Unknown Affiliation
van der Walt, Martie L.
Unknown Affiliation
Van Derwerf, Tjip S.
Unknown Affiliation
Viiklepp, Piret
Unknown Affiliation
Westenhouse, Janice L.
Unknown Affiliation
Yew, Wing W.
Unknown Affiliation
Yim, Jae-joon
Unknown Affiliation
Statistics
Citations: 79
Authors: 79
Affiliations: 20
Identifiers
Doi:
10.1183/09031936.00134712
ISSN:
09031936
e-ISSN:
13993003
Research Areas
Infectious Diseases
Study Approach
Systematic review