Impact of resistance to first-line and injectable drugs on treatment outcomes in MDR-TB

Hwang, Seung Sik; Kim, H. R.; Kim, H. J.; Kim, M. J.; Lee, Sang‐Min; Yoo, Chul Gyu; Kim, Youngwhan; Han, Sang Beom; Shim, Young‐Soo; Yim, Jae Joon

doi:10.1183/09031936.00099608

Cited by 24 publications

(20 citation statements)

References 14 publications

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“…Thus, it seems very clear that fluoroquinolones are the key in the outcome of MDR-TB and even XDR-TB treatment. Regarding the role of the secondline injectable drugs in the favourable outcome of the MDR-TB patients, the situation is little controversial [6,9,24], although some recent studies suggest that their role is key [25,26].…”

Section: Discussionmentioning

confidence: 99%

Linezolid: an effective, safe and cheap drug for patients failing multidrug-resistant tuberculosis treatment in India

Singla¹,

Caminero²,

Jaiswal³

et al. 2011

Eur Respir J

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Linezolid is identified as an effective drug with which to treat patients failing multidrug-resistant (MDR)-tuberculosis (TB) treatment. However, cost and safety are the concerns. In India, the average price of a 600-mg pill of linezolid is less than one US dollar, much cheaper than most of the third-line drugs.A prospective study of 29 MDR-TB treatment failure patients (16 with laboratory-proven extensively drug-resistant (XDR)-TB and the remaining 13 with MDR-TB with resistance to any quinolone but sensitive to injectables) was carried out in Delhi, India. All patients received daily unsupervised therapy with linezolid, one injectable agent, one fluoroquinolone and two or more other drugs.Patients received a median of six anti-mycobacterial agents. Besides linezolid, capreomycin, moxifloxacin, levofloxacin and amoxycillin-clavulanic acid were used in 41.4%, 58.6%, 41.4%, and 79.3% of patients. Out of a total of 29 patients, 89.7% patients achieved sputum smear and culture conversion; 72.4% showed interim favourable outcome; 10.3% died, 6.8% failed and 10.3% patients defaulted. Linezolid had to be stopped in three (10.3%) patients due to adverse reactions. The outcome of treatment of 16 XDR-TB patients was comparable to the other 13 MDR-TB patients.Linezolid is an effective, cheap and relatively safe drug for patients failing MDR-TB treatment, including those with confirmed XDR-TB.

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Section: Discussionmentioning

confidence: 99%

Linezolid: an effective, safe and cheap drug for patients failing multidrug-resistant tuberculosis treatment in India

Singla¹,

Caminero²,

Jaiswal³

et al. 2011

Eur Respir J

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“…However, HWANG et al [1] found the success rate of treatment of XDR-TB patients to be .50% (23 out of 42 patients). Their success rate was comparable to the standard success rate of MDR-TB (rather than XDR-TB).…”

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confidence: 99%

“…It would therefore have been more appropriate if HWANG et al [1] had discussed the correlation with HIV and TB co-infection in the geographical areas in which the study was carried out.…”

mentioning

confidence: 99%

“…In their retrospective study, HWANG et al [1] found the prevalence of extensively drug-resistant tuberculosis (XDR-TB) to be 21% amongst multidrug-resistant (MDR) patients. However, the available literature indicates that it is around 10% [2].…”

mentioning

confidence: 99%

“…However, the available literature indicates that it is around 10% [2]. The XDR-TB data of HWANG et al [1] was based on the drug susceptibility test for ofloxacin only; it was not performed for other commonly used quinolones. The data would have been higher if drug susceptibility to other commonly used quinolones could have been carried out.…”

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confidence: 99%

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