Abstract
Rationale: Until 2020, extensively drug-resistant tuberculosis (XDR-TB) was defined as TB with resistance to rifampicin and isoniazid (multidrug-resistant TB [MDR-TB]), any fluoroquinolone (FQ), and any second-line injectable drug (SLID). In 2019, the World Health Organization issued new recommendations for treating patients with drug-resistant TB, substantially limiting the role of SLIDs in MDR-TB treatment and thus putting the definition of XDR-TB into question. Objectives: To propose an up-to-date definition for XDR-TB. Methods: We used a large data set to assess treatment outcomes for patients with MDR-TB exposed to any type of longer regimen. We included patients with bacteriologically confirmed MDR-TB and known FQ and SLID resistance results. We performed logistic regression to estimate the adjusted odds ratios (aORs) for an unfavorable treatment outcome (failure, relapse, death, loss to follow-up), and estimates were stratified by the resistance pattern (FQ and/or SLID) and group A drug use (moxifloxacin/levofloxacin, linezolid, and/or bedaquiline). Measurements and Main Results: We included 11,666 patients with MDR-TB; 4,653 (39.9%) had an unfavorable treatment outcome. Resistance to FQs increased the odds of an unfavor...Continue Reading
References
Mar 3, 2007·The European Respiratory Journal·G B MiglioriM C Raviglione
Aug 2, 2007·The European Respiratory Journal·T H Holtz, J P Cegielski
Jun 1, 1947·Tubercle·W H TATTERSALL
Jun 2, 2012·The European Respiratory Journal·Giovanni Battista MiglioriMarieke J van der Werf
Oct 27, 2012·The European Respiratory Journal·Dennis FalzonUNKNOWN Collaborative Group for Meta-Analysis of Individual Patient Data in MDR-TB
Jul 29, 2017·The European Respiratory Journal·Faiz Ahmad KhanDick Menzies
Sep 15, 2018·Lancet·UNKNOWN Collaborative Group for the Meta-Analysis of Individual Patient Data in MDR-TB treatment–2017Dick Menzies
Oct 27, 2018·The European Respiratory Journal·Norbert NdjekaFrancesca Conradie
Nov 14, 2018·The Lancet. Respiratory Medicine·Christoph LangeKeertan Dheda
Nov 22, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·G B Migliori, UNKNOWN Global Tuberculosis Network (GTN)
May 31, 2019·European Respiratory Review : an Official Journal of the European Respiratory Society·Emanuele PontaliUNKNOWN and the writing group members of the Global TB Network Clinical Trials Committee
Dec 22, 2019·The European Respiratory Journal·Syed AbidiFaiz Ahmad Khan
Feb 8, 2020·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Giovanni Battista MiglioriUNKNOWN members of the Global Tuberculosis Network
Jul 25, 2020·The European Respiratory Journal·Zaza AvalianiAskar Yedilbayev
Aug 11, 2020·Lancet·Gregory P BissonSuzanne M Marks