|
KMID : 1044520230860030234
|
|
Tuberculosis and Respiratory Diseases
2023 Volume.86 No. 3 p.234 ~ p.244
|
|
|
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
|
|
Choi Hong-Jo
Jeong Da-Woon
Kang Young-Ae
Jeon Doo-Soo
Kang Hee-Yeon
Kim Hee-Jin
Kim Hee-Sun
Mok Jeong-Ha
|
|
|
Abstract
|
|
|
Background: Effective treatment of fluoroquinolone-resistant multidrug-resistant tuberculosis(FQr-MDR-TB) is difficult because of the limited number of available core anti-TBdrugs and high rates of resistance to anti-TB drugs other than FQs. However, few studieshave examined anti-TB drugs that are effective in treating patients with FQr-MDR-TBin a real-world setting.
Methods: The impact of anti-TB drug use on treatment outcomes in patients with pulmonaryFQr-MDR-TB was retrospectively evaluated using a nationwide integrated TBdatabase (Korean Tuberculosis and Post-Tuberculosis). Data from 2011 to 2017 wereincluded.
Results: The study population consisted of 1,082 patients with FQr-MDR-TB. The overalltreatment 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 susceptiblestrains increased the treatment success rate (vs. unfavorable outcomes). The use ofLFX, CS, EMB, and PTO against susceptible strains decreased the mortality (vs. treatmentsuccess).
Conclusion: A therapeutic regimen guided by drug-susceptibility testing can improvethe 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 andKM may be beneficial for FQr-MDR-TB patients with limited treatment options.
|
|
|
KEYWORD
|
|
|
Fluoroquinolone, Multidrug-Resistant, Outcome, Tuberculosis
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|
|