This study examined the clinical,sociodemographic and treatment-related parameters influencing the therapeutic response to multidrug-resistant(MDR)tuberculosis(TB)treatment in pediatric patients.This multicenter retro...This study examined the clinical,sociodemographic and treatment-related parameters influencing the therapeutic response to multidrug-resistant(MDR)tuberculosis(TB)treatment in pediatric patients.This multicenter retrospective cross-sectional study was conducted in the programmatic management of drug-resistant tuberculosis sites in Khyber Pakhtunkhwa,Pakistan.Basic character-istics,treatment regimens and outcomes were collected from the TB registries.Out of the 450 patients analyzed,79.1%had successful treatment results,achieving the WHO aim of>75%.Similar to previous studies,this study reported a 5.3%death rate and a 5.6%loss to follow-up.Multivariate analysis showed that no history of prior TB treatment was significantly associated with unfavorable outcomes(ad-justed OR:3.1,95%CI:1.9–5.1,P<0.001).Patients on a specific second-line longer treatment regimen(Lfx,Bdq,Cs,Lzd,Cfz,B6)had higher odds of unsuccessful outcomes(adjusted OR:2.0,P=0.009).Furthermore,patients on shorter treatment regimens were substantially more likely to experience unsuccessful outcomes.The study emphasizes the difficulty in treating children with MDR-TB and the importance of creating individualized treatment programs that take each patient’s medical history and resistance profile into ac-count.Although shorter regimens and newer medications seem promising,further research is required to verify their efficacy.展开更多
Objective:To assess the effectiveness and adverse drug reactions of all-oral regimens for patients with multidrug-resistant tuberculosis.Methods:This retrospective study was conducted at 10 Programmatic Management of ...Objective:To assess the effectiveness and adverse drug reactions of all-oral regimens for patients with multidrug-resistant tuberculosis.Methods:This retrospective study was conducted at 10 Programmatic Management of Drug Resistant Tuberculosis sites in Punjab province of Pakistan.Patients receiving treatment for drug resistant tuberculosis from July 2019 to December 2020 with at least interim result i.e.6th month culture conversion or final outcomes(cured,complete,lost to follow-up,failure,death)available,were included in the study.Data was extracted from electronic data management system.For the reporting and management of adverse drug events,active tuberculosis drug safety monitoring and management was implemented across all sites.All the data was analyzed using SPSS version 22.Results:Out of 947 drug resistant tuberculosis patients included in this study,579(68%)of the patients had final outcomes available.Of these,384(67.9%)successfully completed their treatment.Out of 368(32%)patients who had their interim results available,all had their 6th month culture negative.Combining new medications was thought to result in serious adverse outcomes such as QT prolongation.However,this study did not record any severe adverse events among patients.Conclusions:All-oral regimens formulation guided by overall treatment effectiveness resulted in treatment outcomes comparable to those obtained with traditional injectable treatment.展开更多
基金supported by the Researchers Supporting Project(project number RSP2024R378),King Saud University,Riyadh,Saudi Arabia.
文摘This study examined the clinical,sociodemographic and treatment-related parameters influencing the therapeutic response to multidrug-resistant(MDR)tuberculosis(TB)treatment in pediatric patients.This multicenter retrospective cross-sectional study was conducted in the programmatic management of drug-resistant tuberculosis sites in Khyber Pakhtunkhwa,Pakistan.Basic character-istics,treatment regimens and outcomes were collected from the TB registries.Out of the 450 patients analyzed,79.1%had successful treatment results,achieving the WHO aim of>75%.Similar to previous studies,this study reported a 5.3%death rate and a 5.6%loss to follow-up.Multivariate analysis showed that no history of prior TB treatment was significantly associated with unfavorable outcomes(ad-justed OR:3.1,95%CI:1.9–5.1,P<0.001).Patients on a specific second-line longer treatment regimen(Lfx,Bdq,Cs,Lzd,Cfz,B6)had higher odds of unsuccessful outcomes(adjusted OR:2.0,P=0.009).Furthermore,patients on shorter treatment regimens were substantially more likely to experience unsuccessful outcomes.The study emphasizes the difficulty in treating children with MDR-TB and the importance of creating individualized treatment programs that take each patient’s medical history and resistance profile into ac-count.Although shorter regimens and newer medications seem promising,further research is required to verify their efficacy.
文摘Objective:To assess the effectiveness and adverse drug reactions of all-oral regimens for patients with multidrug-resistant tuberculosis.Methods:This retrospective study was conducted at 10 Programmatic Management of Drug Resistant Tuberculosis sites in Punjab province of Pakistan.Patients receiving treatment for drug resistant tuberculosis from July 2019 to December 2020 with at least interim result i.e.6th month culture conversion or final outcomes(cured,complete,lost to follow-up,failure,death)available,were included in the study.Data was extracted from electronic data management system.For the reporting and management of adverse drug events,active tuberculosis drug safety monitoring and management was implemented across all sites.All the data was analyzed using SPSS version 22.Results:Out of 947 drug resistant tuberculosis patients included in this study,579(68%)of the patients had final outcomes available.Of these,384(67.9%)successfully completed their treatment.Out of 368(32%)patients who had their interim results available,all had their 6th month culture negative.Combining new medications was thought to result in serious adverse outcomes such as QT prolongation.However,this study did not record any severe adverse events among patients.Conclusions:All-oral regimens formulation guided by overall treatment effectiveness resulted in treatment outcomes comparable to those obtained with traditional injectable treatment.
