Treatment responses in multidrug-resistant tuberculosis in Germany

J. Heyckendorf, F. Van Leth, K. Avsar, G. Glattki, G. Günther, B. Kalsdorf, M. Müller, I.D. Olaru, T. Rolling, H.J.F. Salzer, M. Schuhmann, E. Terhalle, C. Lange

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

© 2018 The Union.BACKGROUND: Excellent treatment outcomes have recently been reported for patients with multi/extensively drug-resistant tuberculosis (M/XDR-TB) in settings where optimal resources for individualised therapy are available. OBJECTIVE : To ascertain whether differences remain in treatment responses between patients with M/XDR-TB and those with non-M/XDR-TB. METHOD: Patients with TB were prospectively enrolled between March 2013 and March 2016 at five hospitals in Germany. Treatment was conducted following current guidelines and individualised on the basis of drug susceptibility testing. Two-month and 6-month sputum smear and sputum culture conversion rates were assessed. A clinical and radiological score were used to assess response to anti-Tuberculosis treatment. RESULT S : Non-M/XDR-TB (n 29) and M/XDR-TB (n46) patients showed similar rates of microbiological conversion: 2-month smear conversion rate, 90% vs. 78%; culture conversion rate, 67% vs. 61%; time to smear conversion, 19 days (IQR 10-32) vs. 31 days (IQR 14-56) (P0.066); time to culture conversion, 39 days (IQR 17-67) vs. 39 days (IQR 6-85) (P 0.191). Both clinical and radiological scores decreased after the introduction of anti-Tuberculosis treatment. CONCLUS ION: There were no significant differences in scores between the two groups until 6 months of treatment. Under optimal clinical conditions, with the availability of novel diagnostics and a wide range of therapeutic options for individualised treatment, patients with M/XDR-TB achieved 6-month culture conversion rates that were compatible with those in patients with non-M/XDR-TB.
Original languageEnglish
Pages (from-to)399-406
JournalInternational journal of tuberculosis and lung disease
Volume22
Issue number4
DOIs
Publication statusPublished - 1 Apr 2018
Externally publishedYes

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