Ketahanan hidup 2 tahun pasien tuberkulosis resisten obat di RS. Moewardi Surakarta tahun 2010-2014

Two year survival of drug resistant tuberculosis patients in Moewardi hospital in Surakarta in 2010-2014PurposeThe purpose of this study was to determine the two year survival rate and predictor factors of mortality in drug resistant tuberculosis patients during treatment at the Moewardi Hospital in Surakarta.MethodsThis research was a retrospective cohort study of 250 drug resistant tuberculosis patients receiving treatment in the Moewardi Hospital in January 2011-September 2014. Data were analyzed using survival analysis to find factors affecting the 2 year survival. Our variables were demographic factors, disease characteristics and treatment history. We used Cox regression test with 5% significance level.Results2-year survival rates of drug resistant patients was 74.82%. age, the type of patient, HIV status, side effects of medications and culture conversion were significant to survival rate in bivariate analysis. Cox regression test showed that aged ≥ 40 years (HR 3.221; 95% CI 1.037 to 10.001) and have HIV-positive status (HR 18.086; 95% CI 1.958 to 167.073) were related with reduction of two year survival rate in drug resistant tuberculosis patient. ConclusionAge above 40 years old and HIV positive status for drug-resistant tuberculosis patients may accelerate their death. The screening of HIV in drug resistant tuberculosis patients is needed in order to increase two year survival rate of patients during treatment.

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Early treatment outcome of bedaquiline plus optimised background regimen in drug resistant tuberculosis patients

Indian Journal of Tuberculosis ◽

10.1016/j.ijtb.2020.03.002 ◽

2020 ◽

Vol 67 (2) ◽

pp. 222-230

Author(s):

Sandip V. Barvaliya ◽

Mira K. Desai ◽

Jigar R. Panchal ◽

Rajesh N. Solanki

Keyword(s):

Treatment Outcome ◽

Early Treatment ◽

Drug Resistant ◽

Drug Resistant Tuberculosis ◽

Tuberculosis Patients ◽

Resistant Tuberculosis ◽

Background Regimen

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P96 Characteristics and outcomes of multi-drug resistant tuberculosis patients in a major urban centre in the UK: Abstract P96 Table 1.

Thorax ◽

10.1136/thoraxjnl-2013-204457.246 ◽

2013 ◽

Vol 68 (Suppl 3) ◽

pp. A118.2-A118

Author(s):

GC Hagan ◽

F Edwards ◽

J Nation ◽

H Kunst ◽

M Dedicoat ◽

...

Keyword(s):

Drug Resistant ◽

Urban Centre ◽

Drug Resistant Tuberculosis ◽

Tuberculosis Patients ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis ◽

Major Urban Centre ◽

The Uk

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Optimized loading dose strategies for bedaquiline when restarting interrupted drug-resistant tuberculosis treatment

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01749-21 ◽

2022 ◽

Author(s):

Simon E Koele ◽

Stijn W van Beek ◽

Gary Maartens ◽

James C. M. Brust ◽

Elin M Svensson

Keyword(s):

Treatment Interruption ◽

Loading Dose ◽

Drug Resistant ◽

Time Curve ◽

Resistance Development ◽

Drug Resistant Tuberculosis ◽

Tuberculosis Patients ◽

Resistant Tuberculosis ◽

Starting Point ◽

One Year

Interruption of treatment is common in drug-resistant tuberculosis patients. Bedaquiline has a long terminal half-life therefore, restarting after an interruption without a loading dose could increase the risk of suboptimal treatment outcome and resistance development. We aimed to identify the most suitable loading dose strategies for bedaquiline restart after an interruption. A model-based simulation study was performed. Pharmacokinetic profiles of bedaquiline and its metabolite M2 (associated with QT-prolongation) were simulated for 5000 virtual patients for different durations and starting points of treatment interruption. Weekly bedaquiline area under the concentration-time curve (AUC) and M2 maximum concentration (Cmax) deviation before interruption and after reloading were assessed to evaluate the efficacy and safety respectively of the reloading strategies. Bedaquiline weekly AUC and M2 Cmax deviation were mainly driven by the duration of interruption and only marginally by the starting point of interruption. For interruptions with a duration shorter than two weeks, no new loading dose is needed. For interruptions with durations between two weeks and one month, one month and one year, and longer than one year, reloading periods of three days, one week, and two weeks, respectively, are recommended. This reloading strategy results in an average bedaquiline AUC deviation of 1.88% to 5.98% compared with -16.4% to -59.8% without reloading for interruptions of two weeks and one year respectively, without increasing M2 Cmax. This study presents easy-to-implement reloading strategies for restarting a patient on bedaquiline treatment after an interruption.

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