Is adding fluoroquinolones to regimens for treating isoniazid-resistant tuberculosis necessary?
Resistance against first-line drugs for treating tuberculosis (TB) continues to be a major public health challenge that hampers the World Health Organization (WHO)'s End TB strategy . The End TB strategy aims to reduce TB deaths by 95% and new TB cases by 90% between 2015 and 2035. In 2017, the WHO recorded 558 000 cases (range 483 000–639 000) of TB not treatable with rifampicin, the most effective first-line anti-TB drug. Of these, 82% cases were of multidrug-resistant TB (MDR-TB) .
Authors: Ali MH, Alrasheedy AA, Kibuule D, Godman B, Hassali MA, Ali HMH Abstract Background: Multidrug-resistant Tuberculosis (MDR-TB) has socioeconomic impact and threatens global public health. We assessed treatment outcomes of MDR-TB and predictors of poor treatment outcomes in Sudan given current high prevalence rates.Methods: Combined retrospective and prospective cohort study at Abu-Anga hospital (TB specialized hospital in Sudan). All patients with MDR-TB between 2013-2017 were targeted.Results: 156 patients were recruited as having good records, 117 (75%) were male, and 152 (97.4%) had pulmonary TB (PTB). ...
A phase III trial of delamanid showed acceptable safety and tolerability; however, it failed to demonstrate superior efficacy of delamanid in terms of reduction in time to sputum conversion and improvement in final treatment outcomes compared with placebo . How to interpret these results and identify the role of delamanid in multidrug-resistant tuberculosis (MDR-TB) treatment is challenging . Despite the disappointing results, this trial suggests that more studies are needed to better understand the role of delamanid in the current management of MDR-TB. So far, there have been several reports of real-world data on th...
CONCLUSION: Three (-)-camphene derivatives have shown to be promising anti-TB molecule scaffold due to the low MIC values in acidic pH against MDR M. tuberculosis clinical isolates, synergism with PZA and low cytotoxicity. PMID: 31702530 [PubMed - as supplied by publisher]
Conclusions: In this study, we found higher proportion of MDR/XDR-TB among re-treated cases than initial treated cases in China and the drug resistance rate of tuberculosis varied with age, sex, and region, indicating that standardized anti-tuberculosis treatment can reduce the incidence of drug-resistant tuberculosis and the recurrence of tuberculosis.
Conclusion: The variability in tuberculosis epidemiology across regions was likely due to differences in the quality of antituberculosis services. Precision in defining necessary interventions, as determined through the principal coordinate analysis approach, can guide focused tuberculosis control efforts. PMID: 31673189 [PubMed - in process]
Conclusions: Even though the mortality rates of all HIV and TB co-infection types have decreased recently, the overall trends in both incidence and prevalence rates of HIV-infected DS-TB and XDR-TB have been increasing since 1990. Efforts to control co-infection across drug resistance types should be continued and further strengthened. PMID: 31656655 [PubMed]
CONCLUSIONS: The QMAP MDR/XDR assay can detect all known DNA mutations associated with drug resistance for both MDR- and XDR-MTB strains. It can be used for molecular diagnosis of MDR- and XDR-TB to rapidly initiate appropriate anti-TB drug therapy. PMID: 31650730 [PubMed - in process]
Publication date: December 2019Source: Infectious Disease Clinics of North America, Volume 33, Issue 4Author(s): Simon Tiberi, Alimuddin Zumla, Giovanni Battista Migliori
This article reviews epidemiology, clinical features, management, and treatment, with new updates and recent changes in guidelines that offer patients better tolerated and shorter regimens for enabling therapeutic outcomes.
This study (10,160 household contacts [HCs] of 3339 index patients) found HCs exposed to patients with multidrug resistant TB had 8% higher risk of infection by end of follow-up vs. HCs of patients with drug sensitive TB. Risk of TB disease did not differ among contacts in both groups.