scholarly journals Efficacy and safety of short course chemotherapy regimens in older children and adolescents with multiple and extensive drug resistant respiratory tuberculosis

2021 ◽  
Vol 99 (10) ◽  
pp. 35-39
Author(s):  
L. V. Panova ◽  
E. S. Ovsyankina ◽  
E. A. Krushinskaya ◽  
A. Yu. Khiteva ◽  
O. A. Piskunova
Keyword(s):  
Children And Adolescents ◽  
Controlled Study ◽  
Drug Resistant ◽  
Efficacy And Safety ◽  
Older Children ◽  
Continuation Phase ◽  
Intensive Phase ◽  
Resistant Tuberculosis ◽  
Short Course ◽  
Short Course Chemotherapy

The objective of the study: to evaluate the efficacy and safety of short course chemotherapy regimens for multiple/extensive drug resistant tuberculosis of the respiratory system (MDR/XDR) in older children and adolescents.Subjects and Methods. A cohort prospective controlled study (2017 to 2019) included 23 patients from 13 to 17 years old with various clinical forms of respiratory tuberculosis with multiple/extensive drug resistance.Results. In 22 out of 23 cases, the following chemotherapy regimen was used: 6 months - the intensive phase / 6 months - the continuation phase, in one patient – 3 months of the intensive phase / 9 months of the continuation phase. In 15 out of 23 cases, the chemotherapy regimens in the intensive phase, taking into account the MBT drug sensitivity test, consisted of 5 drugs, in 8 cases – of 4 drugs. During the continuation phase, all patients received 3 drugs. Of the 23 patients, 8 patients used bedaquiline in short course chemotherapy regimens: 2 – 1 course, 6 – 2 courses.Conclusion. The possibility of reducing the main course of chemotherapy for MDR/XDR TB in children and adolescents to 12 months instead of 18-24 months has been proved.

scholarly journals Standard Short-Course Chemotherapy for Drug-Resistant Tuberculosis

JAMA ◽  
2000 ◽  
Vol 283 (19) ◽  
pp. 2537 ◽  
Author(s):  
Marcos A. Espinal ◽  
Sang Jae Kim ◽  
Pedro G. Suarez ◽  
Kai Man Kam ◽  
Alexander G. Khomenko ◽  
...  
Keyword(s):  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Short Course ◽  
Short Course Chemotherapy

scholarly journals Short course chemotherapy in children suffering from drug resistant tuberculosis

2021 ◽  
Vol 99 (2) ◽  
pp. 34-39
Author(s):  
N. I. Klevno ◽  
V. A. Аksenova ◽  
A. V. Kazakov ◽  
E. B. Kovalevskaya
Keyword(s):  
Multiple Drug Resistance ◽  
Previous Treatment ◽  
Resistance Pattern ◽  
Multiple Drug ◽  
Drug Resistant ◽  
Aminosalicylic Acid ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Short Course ◽  
Short Course Chemotherapy

The objective: to study the effect of short course chemotherapy regimens on treatment outcomes in children with drug resistant tuberculosis.Subjects and methods. In 2017-2019, 31 children at the age from 3 to 17 years old, received short course chemotherapy which lasted for 12-15 months. Children of both genders were enrolled in the study, they all were new pulmonary tuberculosis cases with multiple drug resistance or at risk of MDR, with no history of previous treatment with reserve anti-tuberculosis drugs, and without severe concomitant diseases. Before the treatment was prescribed, all children underwent lung computed tomography additionally to general clinical and laboratory tests.Results. The chemotherapy regimen for each child consisted of 4-6 drugs selected individually with the consideration of resistance pattern of the child or suspected index case. In all cases, the combination of drugs included fluoroquinolones (levofloxacin or moxifloxacin). Amikacin (67.7%), aminosalicylic acid (80.6%) and prothionamide (74.2%) were frequently prescribed. 54.8% of children received pyrazinamide and 48.4% – cycloserine. Given the limited lesions, only 16.1% of children received linezolid and 9.7% of children received bedaquiline. The main chemotherapy course made 13.2 ± 0.5 months (from 12 to 15 months depending on the form of tuberculosis and changes during treatment). The duration of the intensive phase made 4.8 ± 0.3 on the average. 2 (6.5 ± 4.4%) of 31 children developed adverse events requiring the cancellation of the drugs causing them.Conclusion. This study has demonstrated satisfactory tolerability and good efficacy of these short course regimens for treatment of multiple drug resistant tuberculosis. No relapses of tuberculosis were reported.

scholarly journals A STUDY ON LIVER FUNCTION TEST PROFILE OF 2ND LINE DRUGS IN MULTI DRUG RESISTANT (MDR) AND EXTENSIVELY DRUG RESISTANT (XDR) TUBERCULOSIS CASES REGISTERED UNDER DR-TB CENTRE IN A TERTIARY CARE HOSPITAL

2020 ◽  
pp. 1-3
Author(s):  
Rupam Kumar Ta ◽  
Pronoy Sen
Keyword(s):  
Adverse Drug Reactions ◽  
Initial Period ◽  
Care Hospital ◽  
Drug Resistant ◽  
Drug Reactions ◽  
Drug Resistant Tuberculosis ◽  
Intensive Phase ◽  
Tb Control ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant

BACKGROUND: The emergence of drug resistant mycobacterium has become a signicant public health problem creating an obstacle to effective Tuberculosis (TB) control. Freedom from TB is possible with timely, regular, complete treatment, with assurance, prevention and management of side effects of antitubercular drugs. Present study was conducted to evaluate common and rare adverse drug reactions (ADR) of CAT IV and CAT V to analyse demographic, radiological and bacteriological prole and treatment outcome in MDR &XDR patients. Aims and Objectives- To evaluate the common and rare adverse drug reactions of intensive phase treatment of Multi Drug Resistant Tuberculosis (MDR) and Extensively Drug Resistant Tuberculosis (XDR) as per WHO-UMC Causality Assessment Scale. METHODS: 76 patients of MDR and XDR Tuberculosis were admitted in DR-TB (Drug Resistant TB) centre, Burdwan Medical College and Hospital and the adverse drug reaction prole of 2nd line drugs were analysed during the intensive phase for a year after fullling the inclusion and exclusion criteria. Treatment was given as per guidelines by Revised National TB Control Program PMDT (Programmatic management of drug-resistant TB). RESULTS:Adverse drug reactions on GI system were nausea 73 patients (96.10%), vomiting 70 (92.10%), acidity 41 (53.9%), and sulphurous belching and hepatitis 1 (1.31%) each. CONCLUSIONS: The reactions were common in rst 60 days of the regimen and in patients with BMI ≤18. Hence vigilant monitoring is required for these types of patients during the initial period and sputum smear and culture conversion is very well correlated with clinical and radiological improvement.

scholarly journals Efficacy and Safety of Lurasidone in Children and Adolescents With Bipolar I Depression: A Double-Blind, Placebo-Controlled Study

2017 ◽  
Vol 56 (12) ◽  
pp. 1015-1025 ◽  
Author(s):  
Melissa P. DelBello ◽  
Robert Goldman ◽  
Debra Phillips ◽  
Ling Deng ◽  
Josephine Cucchiaro ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Controlled Study ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Double Blind Placebo

scholarly journals Intensive phase treatment outcome and associated factors among patients treated for multi drug resistant tuberculosis in Ethiopia: a retrospective cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Teklu Molie ◽  
Zelalem Teklemariam ◽  
Eveline Klinkenberg ◽  
Yadeta Dessie ◽  
Andargachew Kumsa ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Retrospective Cohort ◽  
Multinomial Logistic Regression ◽  
Drug Resistant ◽  
Contributing Factors ◽  
Drug Resistant Tuberculosis ◽  
Intensive Phase ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb

Abstract Background Multi-drug resistant Tuberculosis (MDR-TB) is a strain of Mycobacterium tuberculosis that is resistant to at least Rifampicin and Isoniazid drugs. The treatment success rate for MDR-TB cases is lower than for drug susceptible TB. Globally only 55% of MDR-TB patients were successfully treated. Monitoring the early treatment outcome and better understanding of the specific reasons for early unfavorable and unknown treatment outcome is crucial for preventing the emergence of further drug-resistant tuberculosis. However, this information is scarce in Ethiopia. Therefore, this study aimed to determine the intensive phase treatment outcome and contributing factors among patients treated for MDR-TB in Ethiopia. Methods A 6 year retrospective cohort record review was conducted in fourteen TICs all over the country. The records of 751 MDR-TB patients were randomly selected using simple random sampling technique. Data were collected using a pre-tested and structured checklist. Multivariable multinomial logistic regression was undertaken to identify the contributing factors. Results At the end of the intensive phase, 17.3% of MDR-TB patients had an unfavorable treatment outcome, while 16.8% had an unknown outcome with the remaining having a favorable outcome. The median duration of the intensive phase was 9.0 months (IQR 8.04–10.54). Having an unfavorable intensive phase treatment outcome was found significantly more common among older age [ARRR = 1.047, 95% CI (1.024, 1.072)] and those with a history of hypokalemia [ARRR = 0.512, 95% CI (0.280, 0.939)]. Having an unknown intensive phase treatment outcome was found to be more common among those treated under the ambulatory care [ARRR = 3.2, 95% CI (1.6, 6.2)], rural dwellers [ARRR = 0.370, 95% CI (0.199, 0.66)], those without a treatment supporter [ARRR = 0.022, 95% CI (0.002, 0.231)], and those with resistance to a limited number of drugs. Conclusion We observed a higher rate of unfavorable and unknown treatment outcome in this study. To improve favorable treatment outcome more emphasis should be given to conducting all scheduled laboratory monitoring tests, assignment of treatment supporters for each patient and ensuring complete recording and reporting which could be enhanced by quarterly cohort review. Older aged and rural patients need special attention. Furthermore, the sample referral network should be strengthened.

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