Short-Course Regimen for Multidrug-Resistant Tuberculosis: A Decade of Evidence
About ten years ago, the first results of the so-called "Bangladesh regimen", a short regimen lasting nine months instead of 20 months, revolutionized multidrug-resistant tuberculosis (MDR-TB) treatment. Similar short regimens were studied in different settings, relying for their efficacy...
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| Veröffentlicht in: | Journal of clinical medicine 2019-12, Vol.9 (1), p.55 |
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| container_title | Journal of clinical medicine |
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| creator | Trébucq, Arnaud Decroo, Tom Van Deun, Armand Piubello, Alberto Chiang, Chen-Yuan Koura, Kobto G Schwoebel, Valérie |
| description | About ten years ago, the first results of the so-called "Bangladesh regimen", a short regimen lasting nine months instead of 20 months, revolutionized multidrug-resistant tuberculosis (MDR-TB) treatment. Similar short regimens were studied in different settings, relying for their efficacy on a later generation fluoroquinolone, either gatifloxacin, moxifloxacin, or levofloxacin. We review the published material on short MDR-TB regimens, describe their different compositions, their results in national tuberculosis programs in middle- and low-income countries, the risk of acquiring resistance to fluoroquinolone, and the occurrence of adverse events. With over 80% success, the regimen performs much better than longer regimens (usually around 50%). Monitoring of adverse events allows adapting its composition to prevent severe adverse events such as deafness. We discuss the current applicability and usefulness of the short injectable-containing regimen given the 2019 recommendation of the World Health Organization (WHO) for a new long all-oral regimen. We conclude that the most effective fluoroquinolone is gatifloxacin, currently not listed as an essential medicine by WHO. It is a priority to restore its status as an essential medicine. |
| doi_str_mv | 10.3390/jcm9010055 |
| format | Article |
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Similar short regimens were studied in different settings, relying for their efficacy on a later generation fluoroquinolone, either gatifloxacin, moxifloxacin, or levofloxacin. We review the published material on short MDR-TB regimens, describe their different compositions, their results in national tuberculosis programs in middle- and low-income countries, the risk of acquiring resistance to fluoroquinolone, and the occurrence of adverse events. With over 80% success, the regimen performs much better than longer regimens (usually around 50%). Monitoring of adverse events allows adapting its composition to prevent severe adverse events such as deafness. We discuss the current applicability and usefulness of the short injectable-containing regimen given the 2019 recommendation of the World Health Organization (WHO) for a new long all-oral regimen. We conclude that the most effective fluoroquinolone is gatifloxacin, currently not listed as an essential medicine by WHO. It is a priority to restore its status as an essential medicine.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm9010055</identifier><identifier>PMID: 31881691</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Antibiotics ; Clinical medicine ; Drug dosages ; Multidrug resistant organisms ; Review ; Success ; Tuberculosis</subject><ispartof>Journal of clinical medicine, 2019-12, Vol.9 (1), p.55</ispartof><rights>2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). 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| subjects | Antibiotics Clinical medicine Drug dosages Multidrug resistant organisms Review Success Tuberculosis |
| title | Short-Course Regimen for Multidrug-Resistant Tuberculosis: A Decade of Evidence |
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