what is the standard treatment for drug-resistant TB?

Category: Tuberculosis

πŸ“Š 91 findings in 7 studies
Intervention Condition Outcome / Effect Source
πŸ“Š Second-line drug susceptibility testing
vs No second-line DST (standardiz
Multidrug-Resistant Tuberculosis
Rifampin-resistant tuberculosi
Implementing second-line DST for all patients with rifampin-resistant tuberculosis could substantial
Not specified (qualitative: 'substantial
↑ 5576040
πŸ“Š Second-line drug susceptibility testing
vs No second-line DST (standardiz
Multidrug-Resistant Tuberculosis
Rifampin-resistant tuberculosi
Implementing second-line DST for all patients with rifampin-resistant tuberculosis could reduce tran
Not specified (qualitative: 'reduce tran
↑ 5576040
πŸ“Š Second-line drug susceptibility testing
vs No second-line DST (standardiz
Multidrug-Resistant Tuberculosis
Rifampin-resistant tuberculosi
Implementing second-line DST for all patients with rifampin-resistant tuberculosis could prevent amp
Not specified (qualitative: 'prevent amp
↑ 5576040
πŸ“Š Second-line drug susceptibility testing
vs No second-line DST (standardiz
Multidrug-Resistant Tuberculosis
Rifampin-resistant tuberculosi
Implementing second-line DST for all patients with rifampin-resistant tuberculosis could be affordab
Not specified (qualitative: 'be affordab
↑ 5576040
πŸ“Š Standardized treatment regimens
vs Individualized regimens based
Multidrug-Resistant Tuberculosis
Rifampin-resistant tuberculosi
Standardized treatment regimens without second-line DST reduce the probability of treatment success
Not specified (qualitative: 'reduce the
↓ 5576040
πŸ“Š Standardized treatment regimens
vs Individualized regimens based
Multidrug-Resistant Tuberculosis
Rifampin-resistant tuberculosi
Standardized treatment regimens without second-line DST expose patients to toxicity without benefit.
Not specified (qualitative: 'expose pati
Side effects: Toxicity without benefit
↓ 5576040
πŸ“Š Standardized treatment regimens
vs Individualized regimens based
Multidrug-Resistant Tuberculosis
Rifampin-resistant tuberculosi
Standardized treatment regimens without second-line DST amplify drug resistance in rifampin-resistan
Not specified (qualitative: 'amplify dru
Side effects: Amplification of drug resistance
↓ 5576040
πŸ“Š Number of effective drugs in
vs Regimens with fewer effective
Multidrug-Resistant Tuberculosis
Rifampin-resistant tuberculosi
Each additional effective drug in the regimen increases the probability of treatment success in rifa
Each additional effective drug increases
↑ 5576040
πŸ“Š Second-line drug susceptibility testing
vs No second-line DST
Multidrug-Resistant Tuberculosis
Rifampin-resistant tuberculosi
Second-line DST enables rapid identification of appropriate candidates for the 9-month regimen for r
Not specified (qualitative: 'rapidly ide
↑ 5576040
πŸ“Š Second-line drug susceptibility testing
vs No second-line DST
Multidrug-Resistant Tuberculosis
Rifampin-resistant tuberculosi
Second-line DST represents a small incremental cost (about 2% of total treatment cost per patient) i
Second-line DST cost is about 2% of tota
↑ 5576040
πŸ“Š Second-line drug susceptibility testing
vs No second-line DST
Multidrug-Resistant Tuberculosis
Rifampin-resistant tuberculosi
Implementing second-line DST for all patients with rifampin-resistant tuberculosis faces significant
Not specified (qualitative: 'logistical
β€” 5576040
πŸ“Š Second-line drug susceptibility testing
vs No second-line DST
Multidrug-Resistant Tuberculosis
Rifampin-resistant tuberculosi
Where second-line DST has been implemented with effective regimens and public health efforts, drug-r
Not specified (qualitative: 'epidemics h
↑ 5576040
A few years
πŸ“Š Second-line drug susceptibility testing
vs No second-line DST
Multidrug-Resistant Tuberculosis
Rifampin-resistant tuberculosi
Second-line DST increases the number of effective drugs in each regimen for rifampin-resistant tuber
Not specified (qualitative: 'increase th
↑ 5576040
πŸ“Š Second-line drug susceptibility testing
vs No second-line DST
Multidrug-Resistant Tuberculosis
Rifampin-resistant tuberculosi
Second-line DST enables more rapid initiation of effective therapy for rifampin-resistant tuberculos
Not specified (qualitative: 'rapidly ini
↑ 5576040
πŸ“Š Second-line drug susceptibility testing
vs Not specified
Multidrug-Resistant Tuberculosis
Rifampin-resistant tuberculosi
Among patients with baseline resistance to 3 or more second-line drugs, 44% acquired XDR during trea
44% of patients with baseline resistance
Side effects: Acquisition of XDR TB
↑ 5576040
During treatment
πŸ“Š Standardized MDR TB treatment Multidrug-Resistant Tuberculosis
Adults
A decentralised model of care for MDR-TB patients in South Africa resulted in a cure rate of 51% as
51% of patients enrolled were cured
↑ 3005763
24 months
πŸ“Š Decentralised model of care for multidru Multidrug-Resistant Tuberculosis
Adults
A decentralised model of care for MDR-TB patients in South Africa resulted in a cure rate of 51% as
51% of patients enrolled were cured
↑ 3005763
24 months
πŸ“Š Standardized MDR TB treatment Multidrug-Resistant Tuberculosis
Adults
In the decentralised model of care for MDR-TB, 15% of patients had their clinical notes lost during
15% of patients' notes were lost (226 of
↓ 3005763
24 months
πŸ“Š Decentralised model of care for MDR-TB Multidrug-Resistant Tuberculosis
Adults
In the decentralised model of care for MDR-TB, 15% of patients had their clinical notes lost during
15% of patients' notes were lost (226 of
↓ 3005763
24 months
πŸ“Š Standardized MDR TB treatment
vs ART initiation within 1 month
Multidrug-Resistant Tuberculosis
Adults
Delayed initiation of ART (7 months after MDR-TB treatment start instead of within 1 month) resulted
ART started 7 months after MDR-TB treatm
↓ 3005763
24 months
πŸ“Š Delayed initiation of antiretroviral the
vs ART initiation within 1 month
Multidrug-Resistant Tuberculosis
Adults
Delayed initiation of ART (7 months after MDR-TB treatment start instead of within 1 month) resulted
ART started 7 months after MDR-TB treatm
↓ 3005763
24 months
πŸ“Š Standardized MDR TB treatment Multidrug-Resistant Tuberculosis
Adults
A public workers’ strike led to 2 months of missed treatment visits (no treatment received) for MDR-
2 months of missed treatment due to stri
↓ 3005763
24 months
πŸ“Š Public workers’ strike Multidrug-Resistant Tuberculosis
Adults
A public workers’ strike led to 2 months of missed treatment visits (no treatment received) for MDR-
2 months of missed treatment due to stri
↓ 3005763
24 months
πŸ“Š Standardized MDR TB treatment
vs No stock-out (full regimen)
Multidrug-Resistant Tuberculosis
Adults
Stock-outs of ofloxacin and ethambutol led to incomplete drug regimens (four drugs instead of five)
Four drugs dispensed instead of five dur
↓ 3005763
24 months
πŸ“Š Drug stock-outs
vs No stock-out (full regimen)
Multidrug-Resistant Tuberculosis
Adults
Stock-outs of ofloxacin and ethambutol led to incomplete drug regimens (four drugs instead of five)
Four drugs dispensed instead of five dur
↓ 3005763
24 months
πŸ“Š Standardized MDR TB treatment Multidrug-Resistant Tuberculosis
Adults
Socio-economic barriers such as impassable roads and lack of transport money led to missed treatment
Missed visits in months 15 and 21 due to
↓ 3005763
24 months
πŸ“Š Standardized MDR TB treatment
vs Adapted regimen (with ethambut
Multidrug-Resistant Tuberculosis
Adults
Loss of clinical notes during treatment led to the issuance of a standardised regimen instead of an
Standardised regimen issued despite need
↓ 3005763
24 months
πŸ“Š Loss of clinical notes during
vs Adapted regimen (with ethambut
Multidrug-Resistant Tuberculosis
Adults
Loss of clinical notes during treatment led to the issuance of a standardised regimen instead of an
Standardised regimen issued despite need
↓ 3005763
24 months
πŸ“Š Greater baseline resistance
vs Optimal treatment (full treatm
Multidrug-Resistant Tuberculosis
Adults
A patient who received full treatment for only 42% of the time, incomplete treatment for 42%, and no
Patient received full treatment for 42%
β€” 3005763
24 months
πŸ“Š Sub-optimal
vs Optimal treatment (full treatm
Multidrug-Resistant Tuberculosis
Adults
A patient who received full treatment for only 42% of the time, incomplete treatment for 42%, and no
Patient received full treatment for 42%
β€” 3005763
24 months
πŸ“Š Prior TB
vs No health system obstacles
Multidrug-Resistant Tuberculosis
Adults
Health system obstacles such as fragmentation of care, irregular drug supplies, inappropriate regime
Increased chances of unsuccessful treatm
↓ 3005763
πŸ“Š Health system obstacles
vs No health system obstacles
Multidrug-Resistant Tuberculosis
Adults
Health system obstacles such as fragmentation of care, irregular drug supplies, inappropriate regime
Increased chances of unsuccessful treatm
↓ 3005763
πŸ“Š Diagnosis in years 2001, 2002, or 2003
vs No quality improvement program
Multidrug-Resistant Tuberculosis
Adults
Implementation of a facility-level quality improvement programme focusing on patient-centred care, a
Facility-level resolution of many proble
↑ 3005763
πŸ“Š Facility-level quality improvement progr
vs No quality improvement program
Multidrug-Resistant Tuberculosis
Adults
Implementation of a facility-level quality improvement programme focusing on patient-centred care, a
Facility-level resolution of many proble
↑ 3005763
πŸ“Š HIV co-infection
vs HIV-negative
Multidrug-Resistant Tuberculosis
MDR TB patients
HIV co-infection increased the risk of treatment default among MDR TB patients.
AOR 2.0
↓ 3005763
up to 2 years
πŸ“Š Male sex hormones borderline
vs Female sex
Multidrug-Resistant Tuberculosis
MDR TB patients
Male sex increased the risk of treatment default among MDR TB patients.
AOR 1.9
↓ 3005763
up to 2 years
πŸ“Š HIV co-infection
vs HIV-negative
Multidrug-Resistant Tuberculosis
MDR TB patients
HIV co-infection was not a significant risk factor for treatment failure among MDR TB patients in mu
Not significant in multivariate analysis
β€” 3005763
up to 2 years
πŸ“Š Imputation of HIV status
vs No imputation
Multidrug-Resistant Tuberculosis
MDR TB patients
Imputation of HIV status for missing data did not significantly affect the association between HIV a
No significant change in effect size or
β€” 3005763
up to 2 years
πŸ“Š Second-line anti-tuberculosis medication Multidrug-Resistant Tuberculosis
Children
In children with MDR-TB in Georgia treated with second-line anti-tuberculosis medications, 77.1% ach
77.1% (95% CI 61.0–87.9)
Side effects: No data collected on adverse events
↑ 3734931
Median 20.5 months (
πŸ“Š Second-line anti-tuberculosis medication Multidrug-Resistant Tuberculosis
Children
Among children with MDR-TB in Georgia treated with second-line anti-tuberculosis medications, 20.0%
20.0%
Side effects: No data collected on adverse events
↓ 3734931
Median 20.5 months
πŸ“Š Second-line anti-tuberculosis medication Multidrug-Resistant Tuberculosis
Children
Among children with MDR-TB in Georgia treated with second-line anti-tuberculosis medications, 2.9% d
2.9%
Side effects: No data collected on adverse events
↓ 3734931
Median 20.5 months
πŸ“Š Second-line anti-tuberculosis medication Multidrug-Resistant Tuberculosis
Children
Among children with MDR-TB or DR-TB in Georgia, 97.6% were culture positive at baseline before start
97.6% culture positive (41/42)
β€” 3734931
πŸ“Š Second-line anti-tuberculosis medication Multidrug-Resistant Tuberculosis
Children
Among children with MDR-TB or DR-TB in Georgia, 70.5% had extra-pulmonary TB (EPTB) at baseline.
70.5% (31/44) had EPTB
β€” 3734931
πŸ“Š Second-line anti-tuberculosis medication Multidrug-Resistant Tuberculosis
Children
Just over half of the children with MDR-TB or DR-TB in Georgia had received previous TB treatment be
51% had previous TB treatment
β€” 3734931
πŸ“Š Second-line anti-tuberculosis medication Multidrug-Resistant Tuberculosis
Children
The median time from diagnosis to treatment initiation with second-line anti-tuberculosis medication
Median 16 days (range 0–311)
β€” 3734931
πŸ“Š Second-line anti-tuberculosis medication Multidrug-Resistant Tuberculosis
Children
The median number of medications used per child with MDR-TB or DR-TB in Georgia was 6 (range 4–9).
Median 6 (range 4–9)
β€” 3734931
πŸ“Š Second-line anti-tuberculosis medication Multidrug-Resistant Tuberculosis
Children
Among children with MDR-TB or DR-TB in Georgia, 97.8% received an injectable agent for at least 6 mo
97.8% (44/45) received injectable agent
β€” 3734931
πŸ“Š Second-line anti-tuberculosis medication Multidrug-Resistant Tuberculosis
Children
Among children with MDR-TB or DR-TB in Georgia, 93.3% received a fluoroquinolone as part of second-l
93.3% (42/45) received fluoroquinolone
β€” 3734931
πŸ“Š Second-line anti-tuberculosis medication Multidrug-Resistant Tuberculosis
Children
Among children with MDR-TB or DR-TB in Georgia, 58% were tested for HIV.
58% tested for HIV
β€” 3734931
πŸ“Š Second-line anti-tuberculosis medication Multidrug-Resistant Tuberculosis
Children
Among children with MDR-TB or DR-TB in Georgia who were tested for HIV, none were HIV positive.
0% HIV positive (0/19 tested)
β€” 3734931
πŸ“Š MDR-TB treatment initiation among preval Multidrug-Resistant Tuberculosis
Global TB patients
Only 20% of MDR-TB cases among prevalent TB patients had access to MDR-TB treatment in 2014.
20%
β€” 5381649
πŸ“Š MDR-TB treatment initiation among notifi Multidrug-Resistant Tuberculosis
Global TB patients
37% of MDR-TB cases among notified TB patients had access to MDR-TB treatment in 2014.
37%
β€” 5381649
πŸ“Š MDR-TB Multidrug-Resistant Tuberculosis
Global TB patients
MDR-TB treatment was successful in only 50% of those who started treatment in 2012.
50%
β€” 5381649
πŸ“Š MDR-TB Multidrug-Resistant Tuberculosis
Global TB patients
Only 10% of MDR-TB cases among prevalent TB patients are expected to be successfully treated.
10%
β€” 5381649
πŸ“Š MDR-TB Multidrug-Resistant Tuberculosis
Global TB patients
Only 11.5% of MDR-TB cases among incident TB patients are expected to be successfully treated.
11.5%
β€” 5381649
πŸ“Š MDR-TB Multidrug-Resistant Tuberculosis
Global TB patients
Only 18.5% of MDR-TB cases among notified TB patients are expected to be successfully treated.
18.5%
β€” 5381649
πŸ“Š Routine drug susceptibility testing cove Multidrug-Resistant Tuberculosis
European TB patients
In Europe, 97% of new and 52% of previously treated TB patients had DST results.
97% (new), 52% (previously treated)
β€” 5381649
πŸ“Š MDR-TB Multidrug-Resistant Tuberculosis
African TB patients
In Africa, nearly 80% of MDR-TB cases estimated to have occurred among notified TB patients were rep
80% (of estimated MDR-TB among notified
β€” 5381649
πŸ“Š MDR-TB Multidrug-Resistant Tuberculosis
European TB patients
In Europe, 59% of estimated MDR-TB cases among notified patients and 40% of estimated MDR-TB cases a
59% (notified), 40% (prevalent)
β€” 5381649
πŸ“Š MDR-TB Multidrug-Resistant Tuberculosis
Global TB patients
Only 23% of estimated, incident MDR-TB patients in a year start treatment.
23%
β€” 5381649
πŸ“Š MDR-TB Multidrug-Resistant Tuberculosis
Global TB patients
Treatment of MDR-TB lasts approximately 18–24 months.
18–24 months
β€” 5381649
πŸ“Š Multidrug-Resistant Tuberculosis Multidrug-Resistant Tuberculosis
MDR-TB patients
MDR-TB treatment resulted in a mean of 8.6 adverse drug reactions (ADRs) per patient as reported by
mean 8.6 ADRs per patient
↓ 4830122
not applicable
πŸ“Š Multidrug-Resistant Tuberculosis Multidrug-Resistant Tuberculosis
MDR-TB patients
MDR-TB treatment resulted in a mean of 1.4 adverse drug reactions (ADRs) per patient as documented i
mean 1.4 ADRs per patient
↓ 4830122
not applicable
πŸ“Š Video recording of patient interview
vs clinician documentation (medic
Multidrug-Resistant Tuberculosis
MDR-TB patients
Patients reported significantly more ADRs (mean 8.6) than were documented in the medical record (mea
t(120) = 19.06, p < 0.001
↓ 4830122
not applicable
πŸ“Š Multidrug-Resistant Tuberculosis Multidrug-Resistant Tuberculosis
MDR-TB patients
67% of MDR-TB patients reported insomnia as an ADR during treatment in patient interviews.
67%
↓ 4830122
not applicable
πŸ“Š Multidrug-Resistant Tuberculosis Multidrug-Resistant Tuberculosis
MDR-TB patients
2% of MDR-TB patients had insomnia documented as an ADR in the medical record during treatment.
2%
↓ 4830122
not applicable
πŸ“Š Multidrug-Resistant Tuberculosis Multidrug-Resistant Tuberculosis
MDR-TB patients
65% of MDR-TB patients reported peripheral neuropathy as an ADR during treatment in patient intervie
65%
↓ 4830122
not applicable
πŸ“Š Multidrug-Resistant Tuberculosis Multidrug-Resistant Tuberculosis
MDR-TB patients
18% of MDR-TB patients had peripheral neuropathy documented as an ADR in the medical record during t
18%
↓ 4830122
not applicable
πŸ“Š Multidrug-Resistant Tuberculosis Multidrug-Resistant Tuberculosis
MDR-TB patients
61% of MDR-TB patients reported confusion or trouble remembering as an ADR during treatment in patie
61%
↓ 4830122
not applicable
πŸ“Š Multidrug-Resistant Tuberculosis Multidrug-Resistant Tuberculosis
MDR-TB patients
4% of MDR-TB patients had confusion or trouble remembering documented as an ADR in the medical recor
4%
↓ 4830122
not applicable
πŸ“Š patient interview vs. clinician document
vs clinician documentation (medic
Multidrug-Resistant Tuberculosis
MDR-TB patients
For all ADRs except hearing loss, there was a significant difference between patient-reported and cl
p < 0.001 for all ADRs except hearing lo
↓ 4830122
not applicable
πŸ“Š Multidrug-Resistant Tuberculosis Multidrug-Resistant Tuberculosis
MDR-TB patients
72% of MDR-TB patients who reported arthralgia as an ADR rated it as 'bothers me a lot' (level 4 sev
72% reported 'bothers me a lot' (level 4
↓ 4830122
not applicable
πŸ“Š Multidrug-Resistant Tuberculosis Multidrug-Resistant Tuberculosis
MDR-TB patients
69% of MDR-TB patients who reported insomnia as an ADR rated it as 'bothers me a lot' (level 4 sever
69% reported 'bothers me a lot' (level 4
↓ 4830122
not applicable
πŸ“Š Multidrug-Resistant Tuberculosis Multidrug-Resistant Tuberculosis
MDR-TB patients
62% of MDR-TB patients who reported changes in vision as an ADR rated it as 'bothers me a lot' (leve
62% reported 'bothers me a lot' (level 4
↓ 4830122
not applicable
πŸ“Š HIV status
vs non-HIV-infected MDR-TB patien
Multidrug-Resistant Tuberculosis
MDR-TB patients
There was no significant difference in the total number of ADRs reported by patient interview betwee
U = 1.09, p = 0.277
β€” 4830122
not applicable
πŸ“Š HIV status
vs non-HIV-infected MDR-TB patien
Multidrug-Resistant Tuberculosis
MDR-TB patients
There was no significant difference in the total number of ADRs documented in the medical record bet
U = 1.66, p = 0.098
β€” 4830122
not applicable
πŸ“Š pH-sensitive, ratiometric GFP Mtb report
vs no conversion at 6 months
Multidrug-Resistant Tuberculosis
Tuberculosis patients
Culture conversion at 6 months in MDR-TB is significantly associated with treatment success compared
adjusted OR 14.07; sensitivity 92%, spec
↑ 6354243
πŸ“Š Culture conversion at 6 months
vs no conversion at 6 months
Multidrug-Resistant Tuberculosis
Tuberculosis patients
Culture conversion at 6 months in MDR-TB is significantly associated with treatment success compared
adjusted OR 14.07; sensitivity 92%, spec
↑ 6354243
πŸ“Š granuloma structure
vs no conversion at 2 months
Multidrug-Resistant Tuberculosis
Tuberculosis patients
Culture conversion at 2 months in HIV-uninfected MDR-TB patients is significantly associated with su
adjusted OR 4.12
↑ 6354243
πŸ“Š Trimethoprim-Sulfamethoxazole Combinatio
vs no conversion at 2 months
Multidrug-Resistant Tuberculosis
Tuberculosis patients
Culture conversion at 2 months in HIV-uninfected MDR-TB patients is significantly associated with su
adjusted OR 4.12
↑ 6354243
πŸ“Š Alcohol use during MDR-TB
vs No alcohol use during MDR-TB t
Multidrug-Resistant Tuberculosis
Adults
Alcohol use during MDR-TB treatment did not significantly increase the frequency of adverse events c
90.9% of drinkers vs. 88.9% of non-drink
Side effects: Most frequent: gastrointestinal (78%), arthralgia
β€” 8324013
Not specified
πŸ“Š Alcohol use during MDR-TB
vs No alcohol use during MDR-TB t
Multidrug-Resistant Tuberculosis
Adults
Alcohol use during MDR-TB treatment was associated with a lower likelihood of favourable treatment o
OR 0.28
↓ 8324013
Not specified
πŸ“Š Alcohol use during MDR-TB
vs No alcohol use during MDR-TB t
Multidrug-Resistant Tuberculosis
Adults
Alcohol use during MDR-TB treatment was associated with increased risk of death during treatment com
P < 0.0001 (direction: increased death)
↓ 8324013
Not specified
πŸ“Š Alcohol use during MDR-TB
vs No alcohol use during MDR-TB t
Multidrug-Resistant Tuberculosis
Adults
Alcohol use during MDR-TB treatment was associated with increased risk of default from treatment com
P < 0.05 (direction: increased default)
↓ 8324013
Not specified
πŸ“Š Alcohol use during MDR-TB
vs No alcohol use during MDR-TB t
Multidrug-Resistant Tuberculosis
Adults
After adjusting for adherence, alcohol use during MDR-TB treatment remained negatively associated wi
Adjusted OR 0.38
↓ 8324013
Not specified
πŸ“Š Alcohol use during MDR-TB
vs No alcohol use during MDR-TB t
Multidrug-Resistant Tuberculosis
Adults
Alcohol use during MDR-TB treatment was not significantly associated with earlier time to default fr
Mean 230 b1 124 days (drinkers) vs. 248
β€” 8324013
Not specified
πŸ“Š Alcohol use during MDR-TB
vs No alcohol use during MDR-TB t
Multidrug-Resistant Tuberculosis
Adults
Alcohol use during MDR-TB treatment was not significantly associated with increased risk of hepatoto
No significant difference at elevations
Side effects: Hepatotoxicity rates not increased in drinkers
β€” 8324013
Not specified
πŸ“Š Alcohol use during MDR-TB
vs No alcohol use during MDR-TB t
Multidrug-Resistant Tuberculosis
Adults
Alcohol use during MDR-TB treatment was not significantly associated with increased permanent interr
No significant difference between drinke
β€” 8324013
Not specified
πŸ“Š Adherence to at least 80% of prescribed
vs Less than 80% adherence
Multidrug-Resistant Tuberculosis
Adults
Among drinkers, adherence to at least 80% of prescribed doses was associated with higher odds of fav
OR 2.89
↑ 8324013
Not specified
πŸ“Š Interruption of treatment due to adverse
vs No interruption due to adverse
Multidrug-Resistant Tuberculosis
Adults
Among drinkers, interruption of treatment due to an adverse event was associated with higher odds of
OR 2.49
↓ 8324013
Not specified
πŸ“Š Diagnosis of alcoholism at baseline
vs No diagnosis of alcoholism at
Multidrug-Resistant Tuberculosis
Adults
Among drinkers, a diagnosis of alcoholism at baseline was associated with worse treatment outcomes.
Direction: worse outcome (no OR reported
↓ 8324013
Not specified
Synopsis

The standard treatment for drug-resistant tuberculosis (specifically multidrug-resistant TB, MDR-TB) involves individualized regimens guided by second-line drug susceptibility testing (DST), which substantially improves treatment outcomes compared to standardized regimens without DST. (5576040) Second-line DST enables rapid identification of appropriate candidates for the 9-month regimen and allows for more rapid initiation of effective therapy in rifampin-resistant TB. (5576040) Standardized treatment regimens without second-line DST reduce the probability of treatment success and can expose patients to toxicity without benefit. (5576040) Each additional effective drug in the regimen increases the probability of treatment success, with fluoroquinolones increasing success rates threefold, second-line injectables twofold, and pyrazinamide twofold. (5576040)

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