Abstract
Introduction: MDR/XDR-TB is associated with lower TB treatment outcome, higher mortality and needs new treatment.
Aims and objectives: to study the efficacy of combination of linezolid, bedaquiline and imipenem in XDR-TB patients' treatment.
Methods: 64 case histories of patients with XDR-TB were analyzed. Patients were divided in two groups: the first group of 37 patients was treated for TB with additional use of linezolid, bedaquiline and imipenem, and the second group of 27 patients was treated with DOTS+ only. Traditional examination including sputum smear, culture, PCR, GeneXpert MTB/RIF, X-ray was performed for all patients.
Results: Most of the patients previously were treated by DOTS and DOTS+ (91.9% and 88.9% respectively for the first and second groups) and had widespread bilateral TB process. All patients had MBT excretion at the beginning. Analysis showed that sputum conversion in the first group after 3-month and 6-month treatment were seen in 59.5% and 70.3% of cases; no conversion was observed in the second group. Sputum conversion in 12-month treatment was much higher in the first group (32 cases, 86.5%) compared to the second group (11 cases, 40.7%, p<0.01). Positive clinical and radiological dynamics of TB process after 12-month treatment in the first group was also statistically more often: in 27 patients from the first group (73.0%) vs. 10 patients in second group (37.0%, p<0.05). There were 4 non TB deaths.
Conclusions: The usage of linezolid, bedaquiline and imipenem combined with TB treatment in XDR-TB patients can notably improve treatment efficacy and can be recommended for the long-term treatment with second-line drugs.
- Copyright ©ERS 2015