Treating children for drug-resistant tuberculosis in Tajikistan with Group 5 medications
File(s)
Author(s)
Type
Journal Article
Abstract
BACKGROUND: Management of extensively drug-resistant tuberculosis (XDR-TB) and pre-XDR-TB is challenging, as effective drugs are lacking. Group 5 anti-tuberculosis drugs have an unclear role in the treatment of drug-resistant TB, and in children the efficacy, safety and effects of long-term use are not well described. We present clinical outcomes and adverse effects of a cohort of children with XDR-TB or pre-XDR-TB treated with Group 5 drugs in Tajikistan.
METHODS: We conducted a retrospective analysis of eight children treated with one or more of the Group 5 drugs available under the Tajikistan National TB Programme—linezolid, amoxicillin-clavulanate, clofazimine and clarithromycin—given in combination with first- and second-line drugs. Time to sputum culture conversion, clinical outcomes and adverse effects were evaluated.
RESULTS: Two children were cured, one completed treatment, four achieved favourable interim outcomes and one died. Adverse effects attributable to linezolid that required drug cessation occurred in one child; adverse effects of the other Group 5 drugs were insignificant or absent, requiring no regimen changes.
CONCLUSION: Group 5 drugs can contribute to effective regimens in children with XDR and pre-XDR-TB. With proper monitoring and aggressive management of adverse effects, their safety profile might be acceptable, even in long-term use.
METHODS: We conducted a retrospective analysis of eight children treated with one or more of the Group 5 drugs available under the Tajikistan National TB Programme—linezolid, amoxicillin-clavulanate, clofazimine and clarithromycin—given in combination with first- and second-line drugs. Time to sputum culture conversion, clinical outcomes and adverse effects were evaluated.
RESULTS: Two children were cured, one completed treatment, four achieved favourable interim outcomes and one died. Adverse effects attributable to linezolid that required drug cessation occurred in one child; adverse effects of the other Group 5 drugs were insignificant or absent, requiring no regimen changes.
CONCLUSION: Group 5 drugs can contribute to effective regimens in children with XDR and pre-XDR-TB. With proper monitoring and aggressive management of adverse effects, their safety profile might be acceptable, even in long-term use.
Date Issued
2016-04-01
Date Acceptance
2015-10-15
Citation
International Journal of Tuberculosis and Lung Disease, 2016, 20 (4), pp.474-478
ISSN
1815-7920
Publisher
International Union Against Tuberculosis and Lung Disease
Start Page
474
End Page
478
Journal / Book Title
International Journal of Tuberculosis and Lung Disease
Volume
20
Issue
4
Copyright Statement
© 2016 The Union
Subjects
Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
Respiratory System
linezolid
clofazimine
amoxicillin-clavulanate
neuropathy
MDR-TB
MULTIDRUG THERAPY
METAANALYSIS
PHARMACOKINETICS
CLOFAZIMINE
OUTCOMES
LEPROSY
Publication Status
Published