The efficacy of all-oral shorter MDR-TB and pre-XDR TB treatment in Russia

INTRODUCTION: treatment success of patients with multidrug and pre-extensively drug-resistant tuberculosis (MDR and pre-XDR-TB) (12-24 months) is 51% in the Russia. AIM: to evaluate the efficacy of treatment with 9-month regimens in MDR and pre-XDR-TB patients. MATERIALS-METHODS: the efficacy of tre...

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Main Authors: Anna Abramchenko, Anastasja Gaida, Mariya Romanova, Galina Mozhokina, Anastasia Samoilova, Irina Vasilyeva
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Global Antimicrobial Resistance
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213716524003254
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Summary:INTRODUCTION: treatment success of patients with multidrug and pre-extensively drug-resistant tuberculosis (MDR and pre-XDR-TB) (12-24 months) is 51% in the Russia. AIM: to evaluate the efficacy of treatment with 9-month regimens in MDR and pre-XDR-TB patients. MATERIALS-METHODS: the efficacy of treatment with 9-month regimens of MDR, pre-XDR-TB in 6 region of the Russian Federation was evaluated. The study included 79 patients: 47 (59.7 %) with MDR-TB and 32 (40.3 %) pre-XDR-TB. 38 (48.4%) were men and 41 (51.6%) were women. The age of patients was 37.1±11.9 years. HIV infection was registered in 9 (12,1%). All patients were confermed positive sputum analysis by microscopic, culture and rapid molecular tests. Treatment regimens included bedaquiline, delamanid, linezolid, and 1-2 drugs: levofloxacin/moxifloxacin, clofazimine, cycloserine/terizidone, pyrazinamide. Treatment efficacy was evaluated by sputum conversion by microscopic and culture methods, as well as positive clinical and radiologic dynamics. Assessment of disease recurrence was performed 1 year after treatment completion. RESULT: Effective treatment was recorded in 64 out of 79 (81%) patients, ineffective in 6 (7.6%). 9 patients dropped out of the study: 4 (5.1%) discontinued treatment, 1(1.3%) died of tuberculosis and 4 (5.1%) died of other causes. By 2 months of treatment, sputum culture conversion was observed in 49 (62%) patients. The median time to culture conversion was 43.5±27.0 days. One patient had a relapse of tuberculosis after one year of follow-up. CONCLUSION: 9-month therapy regimens are characterized by high (81%) treatment efficacy in MDR and pre-XDR TB patients and low relapse rate (1.3%).
ISSN:2213-7165