Drug resistant TB: UK multicentre study (DRUMS): Treatment, management and outcomes in London and West Midlands 2008-2014
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Objectives: Detailed information regarding treatment practices and outcomes of
MDR-TB treatment in the UK is required as a baseline for care improvements.
Methods: 100 consecutive cases between 2008 and 2014 were reviewed retrospectively at 4
MDR-TB treatment centres in England to obtain information on drug treatment choices, hospital
admission duration and outcomes for MDR-TB.
Results: Initial hospital admission was long, median 62.5 (IQR 20e106, n Z 92) days, and 13%
(12/92) of patients lost their home during this period. Prolonged admission was associated with
pulmonary cases, cavities on chest radiograph, a public health policy of waiting for sputum culture
conversion (CC) and loss of the patient’s home. Sputum CC occurred at a median of 33.5
(IQR 16e55, n Z 46) days. Treatment success was high (74%, 74/100) and mortality low (1%, 1/
100). A significant proportion of the cohort had “neutral” results due to deportation and transfer
overseas (12%, (12/100)). 14% (14/100) had negative outcomes for which poor adherence
was the main reason (62%, 9/14).
MDR-TB treatment in the UK is required as a baseline for care improvements.
Methods: 100 consecutive cases between 2008 and 2014 were reviewed retrospectively at 4
MDR-TB treatment centres in England to obtain information on drug treatment choices, hospital
admission duration and outcomes for MDR-TB.
Results: Initial hospital admission was long, median 62.5 (IQR 20e106, n Z 92) days, and 13%
(12/92) of patients lost their home during this period. Prolonged admission was associated with
pulmonary cases, cavities on chest radiograph, a public health policy of waiting for sputum culture
conversion (CC) and loss of the patient’s home. Sputum CC occurred at a median of 33.5
(IQR 16e55, n Z 46) days. Treatment success was high (74%, 74/100) and mortality low (1%, 1/
100). A significant proportion of the cohort had “neutral” results due to deportation and transfer
overseas (12%, (12/100)). 14% (14/100) had negative outcomes for which poor adherence
was the main reason (62%, 9/14).
Date Issued
2016-12-18
Date Acceptance
2016-12-08
Citation
Journal of Infection, 2016, 74 (3), pp.260-271
ISSN
0163-4453
Publisher
Elsevier
Start Page
260
End Page
271
Journal / Book Title
Journal of Infection
Volume
74
Issue
3
Copyright Statement
© 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000397263200005&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
Tuberculosis
PATIENTS RECEIVING TREATMENT
MULTIDRUG-RESISTANT
TREATMENT REGIMEN
SOUTH-AFRICA
TUBERCULOSIS
COST
METAANALYSIS
BEDAQUILINE
DELAMANID
IMPACT
Microbiology
1103 Clinical Sciences
Publication Status
Published