Treatment outcomes of patients with MDR-TB in Nepal on a current programmatic standardised regimen: retrospective single-centre study
Objectives The objectives of this study were to evaluate treatment in patients on current programmatic multidrug-resistant tuberculosis (MDR-TB) regimen and verify eligibility for the 9-month regimen and therapeutic drug monitoring (TDM).Methods We performed a retrospective chart review of patients...
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open Respiratory Research |
| Online Access: | https://bmjopenrespres.bmj.com/content/7/1/e000606.full |
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| author | Daan J Touw Jos G W Kosterink Tjip S van der Werf Jan-Willem Alffenaar Samiksha Ghimire Samriddhi Karki Bhagwan Maharjan Bhabana Shrestha |
| author_facet | Daan J Touw Jos G W Kosterink Tjip S van der Werf Jan-Willem Alffenaar Samiksha Ghimire Samriddhi Karki Bhagwan Maharjan Bhabana Shrestha |
| author_sort | Daan J Touw |
| collection | DOAJ |
| description | Objectives The objectives of this study were to evaluate treatment in patients on current programmatic multidrug-resistant tuberculosis (MDR-TB) regimen and verify eligibility for the 9-month regimen and therapeutic drug monitoring (TDM).Methods We performed a retrospective chart review of patients with MDR-TB receiving standardised regimen at the German Nepal TB Project Clinic, Nepal, between 2014 and 2016. Eligibility for the 9-month regimen and indications for TDM were evaluated.Results Out of 107 available patients’ medical records, 98 were included. In this centre, the MDR-TB treatment success rates were 69.0% in 2015, 86.6% in 2016 and 86.5% in 2017. The median time to sputum smear conversion was 60 days (60–90 IQR) and culture conversion was 60 days (60–90 IQR). Observed side effects did not impact treatment outcomes. No difference in treatment success rates was observed between patients with predisposing risk factors and those without. Only 49% (36/74) of patients were eligible for the 9-month regimen and 23 patients for TDM according to American Thoracic Society guideline criteria.Conclusions Nepalese patients with MDR-TB on ambulatory care had good treatment outcome after programmatic treatment. Implementation of the new WHO oral MDR-TB treatment regimen may further improve treatment results. The 9-month regimen and TDM should be considered as part of programmatic care. |
| format | Article |
| id | doaj-art-88d0f1a45a024a7780c5eddfa5756861 |
| institution | OA Journals |
| issn | 2052-4439 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open Respiratory Research |
| spelling | doaj-art-88d0f1a45a024a7780c5eddfa57568612025-08-20T02:32:53ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392020-09-017110.1136/bmjresp-2020-000606Treatment outcomes of patients with MDR-TB in Nepal on a current programmatic standardised regimen: retrospective single-centre studyDaan J Touw0Jos G W Kosterink1Tjip S van der Werf2Jan-Willem Alffenaar3Samiksha Ghimire4Samriddhi Karki5Bhagwan Maharjan6Bhabana Shrestha7Groningen Research Institute of Pharmacy, Section Pharmaceutical Analysis, University of Groningen, Groningen, The Netherlands4 Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, The NetherlandsInfectious Diseases Service and Tuberculosis Unit, University of Groningen Faculty of Medical Sciences, Groningen, The NetherlandsRijksuniversiteit Groningen, Groningen, The NetherlandsClinical Pharmacy and Pharmacology, University of Groningen Faculty of Medical Sciences, Groningen, The NetherlandsTuberculosis Unit, Nepal Anti-Tuberculosis Association/German Nepal TB Project, Kathmandu, NepalTuberculosis Unit, Nepal Anti-Tuberculosis Association/German Nepal TB Project, Kathmandu, NepalTuberculosis Unit, Nepal Anti-Tuberculosis Association/German Nepal TB Project, Kathmandu, NepalObjectives The objectives of this study were to evaluate treatment in patients on current programmatic multidrug-resistant tuberculosis (MDR-TB) regimen and verify eligibility for the 9-month regimen and therapeutic drug monitoring (TDM).Methods We performed a retrospective chart review of patients with MDR-TB receiving standardised regimen at the German Nepal TB Project Clinic, Nepal, between 2014 and 2016. Eligibility for the 9-month regimen and indications for TDM were evaluated.Results Out of 107 available patients’ medical records, 98 were included. In this centre, the MDR-TB treatment success rates were 69.0% in 2015, 86.6% in 2016 and 86.5% in 2017. The median time to sputum smear conversion was 60 days (60–90 IQR) and culture conversion was 60 days (60–90 IQR). Observed side effects did not impact treatment outcomes. No difference in treatment success rates was observed between patients with predisposing risk factors and those without. Only 49% (36/74) of patients were eligible for the 9-month regimen and 23 patients for TDM according to American Thoracic Society guideline criteria.Conclusions Nepalese patients with MDR-TB on ambulatory care had good treatment outcome after programmatic treatment. Implementation of the new WHO oral MDR-TB treatment regimen may further improve treatment results. The 9-month regimen and TDM should be considered as part of programmatic care.https://bmjopenrespres.bmj.com/content/7/1/e000606.full |
| spellingShingle | Daan J Touw Jos G W Kosterink Tjip S van der Werf Jan-Willem Alffenaar Samiksha Ghimire Samriddhi Karki Bhagwan Maharjan Bhabana Shrestha Treatment outcomes of patients with MDR-TB in Nepal on a current programmatic standardised regimen: retrospective single-centre study BMJ Open Respiratory Research |
| title | Treatment outcomes of patients with MDR-TB in Nepal on a current programmatic standardised regimen: retrospective single-centre study |
| title_full | Treatment outcomes of patients with MDR-TB in Nepal on a current programmatic standardised regimen: retrospective single-centre study |
| title_fullStr | Treatment outcomes of patients with MDR-TB in Nepal on a current programmatic standardised regimen: retrospective single-centre study |
| title_full_unstemmed | Treatment outcomes of patients with MDR-TB in Nepal on a current programmatic standardised regimen: retrospective single-centre study |
| title_short | Treatment outcomes of patients with MDR-TB in Nepal on a current programmatic standardised regimen: retrospective single-centre study |
| title_sort | treatment outcomes of patients with mdr tb in nepal on a current programmatic standardised regimen retrospective single centre study |
| url | https://bmjopenrespres.bmj.com/content/7/1/e000606.full |
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