دورية أكاديمية
Impact of Anti-Tuberculosis Drug Use on Treatment Outcomes in Patients with Pulmonary Fluoroquinolone-Resistant Multidrug-Resistant Tuberculosis: A Nationwide Retrospective Cohort Study with Propensity Score Matching
العنوان: | Impact of Anti-Tuberculosis Drug Use on Treatment Outcomes in Patients with Pulmonary Fluoroquinolone-Resistant Multidrug-Resistant Tuberculosis: A Nationwide Retrospective Cohort Study with Propensity Score Matching |
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المؤلفون: | Hongjo Choi, Dawoon Jeong, Young Ae Kang, Doosoo Jeon, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Jeongha Mok |
المصدر: | Tuberculosis and Respiratory Diseases, Vol 86, Iss 3, Pp 234-244 (2023) |
بيانات النشر: | The Korean Academy of Tuberculosis and Respiratory Diseases, 2023. |
سنة النشر: | 2023 |
المجموعة: | LCC:Diseases of the respiratory system |
مصطلحات موضوعية: | fluoroquinolone, multidrug-resistant, outcome, tuberculosis, Diseases of the respiratory system, RC705-779 |
الوصف: | Background Effective treatment of fluoroquinolone-resistant multidrug-resistant tuberculosis (FQr-MDR-TB) is difficult because of the limited number of available core anti-TB drugs and high rates of resistance to anti-TB drugs other than FQs. However, few studies have examined anti-TB drugs that are effective in treating patients with FQr-MDR-TB in a real-world setting. Methods The impact of anti-TB drug use on treatment outcomes in patients with pulmonary FQr-MDR-TB was retrospectively evaluated using a nationwide integrated TB database (Korean Tuberculosis and Post-Tuberculosis). Data from 2011 to 2017 were included. Results The study population consisted of 1,082 patients with FQr-MDR-TB. The overall treatment outcomes were as follows: treatment success (69.7%), death (13.7%), lost to follow-up or not evaluated (12.8%), and treatment failure (3.9%). On a propensity-score-matched multivariate logistic regression analysis, the use of bedaquiline (BDQ), linezolid (LZD), levofloxacin (LFX), cycloserine (CS), ethambutol (EMB), pyrazinamide, kanamycin (KM), prothionamide (PTO), and para-aminosalicylic acid against susceptible strains increased the treatment success rate (vs. unfavorable outcomes). The use of LFX, CS, EMB, and PTO against susceptible strains decreased the mortality (vs. treatment success). Conclusion A therapeutic regimen guided by drug-susceptibility testing can improve the treatment of patients with pulmonary FQr-MDR-TB. In addition to core anti-TB drugs, such as BDQ and LZD, treatment of susceptible strains with later-generation FQs and KM may be beneficial for FQr-MDR-TB patients with limited treatment options. |
نوع الوثيقة: | article |
وصف الملف: | electronic resource |
اللغة: | English |
تدمد: | 1738-3536 2005-6184 |
Relation: | http://e-trd.org/upload/pdf/trd-2023-0040.pdf; https://doaj.org/toc/1738-3536; https://doaj.org/toc/2005-6184 |
DOI: | 10.4046/trd.2023.0040 |
URL الوصول: | https://doaj.org/article/a2e7797aadf44266a7159fb5c379c16c |
رقم الأكسشن: | edsdoj.2e7797aadf44266a7159fb5c379c16c |
قاعدة البيانات: | Directory of Open Access Journals |
تدمد: | 17383536 20056184 |
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DOI: | 10.4046/trd.2023.0040 |