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Treatment outcomes of multidrug-resistant TB with selective use of new drugs

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SETTING: This was a nationwide cohort study.

OBJECTIVE: To assess the treatment outcomes in patients with multidrug-resistant TB (MDR-TB) who underwent treatment guided by a national TB expert review committee in South Korea.

DESIGN: We enrolled all patients with MDR-TB submitted for approval for the use of new TB drugs, including bedaquiline and delamanid, from 2016 to 2019. Patients were classified into two groups: those on new TB drugs and those not on new TB drugs. We compared the final treatment outcomes between the groups and analysed the prognostic factors.

RESULTS: Of a total of 785 patients, respectively 754 (96.1%) and 31 (3.9%) were classified into the “new TB drugs” group and “no new TB drugs” group. The new TB drugs group had a higher acid-fast bacilli smear positivity rate and higher resistance rate to second-line injectable drugs or fluoroquinolones. Of all the patients, 97.8% achieved culture conversion (97.7% vs. 100%), and 80.4% achieved treatment success (80.2% vs. 86.7%); there was no difference between the two groups.

CONCLUSIONS: New drugs are currently recommended for use in all MDR-TB treatment regimens, and the use of new drugs, as determined by an expert committee, in mainly quinolone-susceptible MDR-TB, did not compromise the treatment success rate.

Keywords: bedaquiline; delamanid; expert committee; multidrug-resistant tuberculosis

Document Type: Research Article

Affiliations: 1: Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea 2: Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea 3: Department of Chest Medicine, Masan National Tuberculosis Hospital, Masan, South Korea 4: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea 5: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea

Publication date: January 1, 2023

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