Source: Annual Congress 2010 - Multidrug-resistant and extensively drug-resistant tuberculosis
Disease area: Respiratory infections

Abstract

Background. XDR TB has emerged worldwide as a threat to public health and TB control, raising concerns of a future epidemic of virtually untreatable disease. Population-based studies on drug susceptibility of TB isolates recently conducted in various countries showed 4% – 19% XDR-TB of all MDR-TB cases. Reported treatment outcomes among patients with XDR-TB vary considerably.
Aim. The aim of the present cohort study was to assess XDR-TB treatment outcome.
Method. 49 XDR-TB patients managed at the Centre in the period ranging from January 2004 to December 2009 with definite outcome were enrolled into the study. In all patients chemotherapy regimen was individually designed on the basis of drug susceptibility testing to both first and second line drugs.
Results. Out of 49 XDR-TB patients enrolled, 27 completed the treatment as planned (giving treatment completion rate 55%), 9 (18%) patients died during the treatment, 7 (14%) patients had never achieved sputum conversion despite strict adherence to the treatment protocol, 6 (12%) patients abandoned the treatment and never restarted it again. Out of 49 patients 6 (12%) interrupted the treatment with following returning to treatment protocol, three of them completed the treatment, two died, one patient had never achieved sputum conversion. Out of 27 who completed the treatment, 23 declared cured giving cure rate 47%.
Conclusions. Our results showing high mortality and low cure rate in patients with XDR-TB suggest employing new strategies to improve outcome. New anti-TB drug regimens, better diagnostic tests and international standards for 2-nd line drug susceptibility testing are needed for effective detection and treatment of XDR-TB.

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Citations should be made in the following way:
A. Skrahina, V. Solodovnikova, A. Astrauko, A. Skrahin, H. Hurevich, L. Surkova (Minsk, Belarus). Extensively drug-resistant tuberculosis (XDR-TB) treatment outcome. Cohort study. Eur Respir J 2010; 36: Suppl. 54, 351

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