Outcomes of bedaquiline-containing regimen in the treatment of adults with drug-resistant tuberculosis in a tertiary care center in Rajasthan

Submitted: April 26, 2023
Accepted: June 6, 2023
Published: August 7, 2023
Abstract Views: 576
PDF: 248
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

The emergence of drug-resistant strains of Mycobacterium tuberculosis has become a significant public health problem and has led to a setback in the efforts to end tuberculosis (TB) worldwide. The longer duration, heavier pill load, and higher toxicity profile of drug-resistant TB regimens compared to those for drug-susceptible TB lead to reduced adherence and worse treatment results, including mortality. This study was conducted to estimate treatment outcomes and adverse effects in patients with drug-resistant TB on a bedaquiline-containing regimen. Patients after the pre-treatment evaluation were enrolled in a bedaquiline-containing regimen. These patients were followed up for 18 months, and the final outcome was assessed along with the adverse effects. It was found that 49 (84.4%) patients achieved culture conversion by 3 months, 54 (93.1%) achieved culture conversion by 6 months, 52 (83.81%) had favorable outcomes (cured, treatment completed), and 10 had unfavorable outcomes (died, lost to follow-up, failed). Coupled with gradually increasing trends in success rates since 2012, lesser failure rates and fewer concerns regarding grave adverse effects are a silver lining in the cloud of increasing burden and widening resistance patterns. More funding has to be directed towards ensuring adherence and finding high-risk individuals to expedite the achievement of sustainable development goals.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

World Health Organization. Global tuberculosis report 2021. Available from: https://www.who.int/publications/i/item/9789240037021.
World Health Organization. Global tuberculosis report 2022. Available from: https://www.who.int/publications/i/item/9789240061729.
Conradie F, Meintjes G, Hughes J, et al. Clinical access to bedaquiline programme for the treatment of drug-resistant tuberculosis. S Afr Med J 2014;104:164-6.
Salhotra VS, Sachdeva KS, Kshirsagar N, et al. Effectiveness and safety of bedaquiline under conditional access program for treatment of drug-resistant tuberculosis in India: an interim analysis. Indian J Tuberc 2020;67:29-37.
Bonnet M, Bastard M, du Cros P, et al. Identification of patients who could benefit from bedaquiline or delamanid: a multisite MDR-TB cohort study. Int J Tuberc Lung Dis 2016;20:177-86.
Pontali E, Visca D, Centis R, et al. Multi and extensively drug-resistant pulmonary tuberculosis: advances in diagnosis and management. Curr Opin Pulm Med 2018;24:244-52.
Guglielmetti L, Le Dû D, Jachym M, et al. Compassionate use of bedaquiline for the treatment of multidrug-resistant and extensively drug-resistant tuberculosis: interim analysis of a French cohort. Clin Infect Dis 2015;60:188-94.
Borisov SE, Dheda K, Enwerem M, et al. Effectiveness and safety of bedaquiline-containing regimens in the treatment of MDR- and XDR-TB: a multicentre study. Eur Respir J 2017;49:1700387.
Mishra G, Alffenaar J-W, Munje R, Khateeb S. Adverse drug reactions due to linezolid in the programmatic management of drug-resistant tuberculosis in India: a retrospective multicenter study. Indian J Tuberc 2023. Online ahead of Print.
Ndjeka N, Conradie F, Schnippel K, et al. Treatment of drug-resistant tuberculosis with bedaquiline in a high HIV prevalence setting: an interim cohort analysis. Int J Tuberc Lung Dis 2015;19:979-85.
Ahmad N, Javaid A, Basit A, et al Management and treatment outcomes of MDR-TB: results from a setting with high rates of drug resistance. Int J Tuberc Lung Dis 2015;19:1109-14.
Katana GG, Ngari M, Maina T, et al. Tuberculosis poor treatment outcomes and its determinants in Kilifi County, Kenya: a retrospective cohort study from 2012 to 2019. Arch Public Health 2022;80:48.
Diacon AH, Pym A, Grobusch MP, et al. Multidrug-resistant tuberculosis and culture conversion with bedaquiline. N Engl J Med 2014;371:723-32.
Ahuja SD, Ashkin D, Avendano M, et al. Multidrug resistant pulmonary tuberculosis treatment regimens and patient outcomes: an individual patient data meta-analysis of 9,153 patients. PLoS Med 2012;9:e1001300.
Pym AS, Diacon AH, Tang S-J, et al. Bedaquiline in the treatment of multidrug- and extensively drug-resistant tuberculosis. Eur Respir J 2016;47:564-74.
Mbuagbaw L, Guglielmetti L, Hewison C, et al. Outcomes of bedaquiline treatment in patients with multidrug-resistant tuberculosis. Emerg Infect Dis 2019;25:936-43.

Ethics Approval

The study protocol was approved by the Institutional Ethical Review Committee - No F.3/Acad/Ethical clearance/2021/51 dated 3.05.2021.

How to Cite

Mary Prince, Roshni, Suman Khangarot, Qazi Faizanul Haque, Anish Mittal, Ramdhan Somani, and Mansha Grover. 2023. “Outcomes of Bedaquiline-Containing Regimen in the Treatment of Adults With Drug-Resistant Tuberculosis in a Tertiary Care Center in Rajasthan”. Monaldi Archives for Chest Disease 94 (2). https://doi.org/10.4081/monaldi.2023.2618.

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.