BACKGROUND: Treatment outcomes in multidrug-resistant TB (MDR-TB) patients are suboptimal in several low-incidence countries.METHODS: The primary outcome measure was the proportion of successfully treated patients in Italy during an 18-year period. Secondary outcomes were treatment outcomes in certain drug-containing regimens and the possibility for the WHO shorter MDR-TB regimen.RESULTS: In the 191 patients included (median age at admission: 33 years; 67.5% male, following drug-resistance patterns were found: MDR-TB in 68.6%, pre-extensively drug-resistant TB (pre-XDR-TB) in 30.4% and XDR-TB in 1.1% patients. The most frequently prescribed drugs were fluoroquinolones in 84.6% cases, amikacin in 48.7%, linezolid in 34.6% and meropenem/clavulanic acid in 29.5%. The median duration of treatment was 18 months. Treatment success was achieved in 71.2% patients, of whom, 44% were cured and 27.2% completed treatment. Treatment success rates did not statistically differ between the MDR- (68.8%) and pre-XDR-TB (77.6%) groups (P = 0.26). Treatment success rates had large variability between North and South of Italy (81.3% vs. 53.3%). Only 22.5% of the cases would have been eligible for shorter MDR-TB regimensCONCLUSION: Our study highlights variability in treatment outcomes in MDR- and pre-XDR-TB patients. Study findings confirmed the potential utility of linezolid and, for patients with limited oral options, meropenem/clavulanic acid and amikacin.

Therapeutic strategies and outcomes of MDR and pre-XDR-TB in Italy: a nationwide study / Riccardi, N.; Saderi, L.; Borroni, E.; Tagliani, E.; Cirillo, D. M.; Marchese, V.; Matteelli, A.; Piana, A.; Castellotti, P.; Ferrarese, M.; Gualano, G.; Palmieri, F.; Girardi, E.; Codecasa, L.; Sotgiu, G.. - In: INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE. - ISSN 1027-3719. - 25:5(2021), pp. 395-399. [10.5588/ijtld.21.0036]

Therapeutic strategies and outcomes of MDR and pre-XDR-TB in Italy: a nationwide study

Saderi L.;Piana A.;Sotgiu G.
2021-01-01

Abstract

BACKGROUND: Treatment outcomes in multidrug-resistant TB (MDR-TB) patients are suboptimal in several low-incidence countries.METHODS: The primary outcome measure was the proportion of successfully treated patients in Italy during an 18-year period. Secondary outcomes were treatment outcomes in certain drug-containing regimens and the possibility for the WHO shorter MDR-TB regimen.RESULTS: In the 191 patients included (median age at admission: 33 years; 67.5% male, following drug-resistance patterns were found: MDR-TB in 68.6%, pre-extensively drug-resistant TB (pre-XDR-TB) in 30.4% and XDR-TB in 1.1% patients. The most frequently prescribed drugs were fluoroquinolones in 84.6% cases, amikacin in 48.7%, linezolid in 34.6% and meropenem/clavulanic acid in 29.5%. The median duration of treatment was 18 months. Treatment success was achieved in 71.2% patients, of whom, 44% were cured and 27.2% completed treatment. Treatment success rates did not statistically differ between the MDR- (68.8%) and pre-XDR-TB (77.6%) groups (P = 0.26). Treatment success rates had large variability between North and South of Italy (81.3% vs. 53.3%). Only 22.5% of the cases would have been eligible for shorter MDR-TB regimensCONCLUSION: Our study highlights variability in treatment outcomes in MDR- and pre-XDR-TB patients. Study findings confirmed the potential utility of linezolid and, for patients with limited oral options, meropenem/clavulanic acid and amikacin.
2021
Therapeutic strategies and outcomes of MDR and pre-XDR-TB in Italy: a nationwide study / Riccardi, N.; Saderi, L.; Borroni, E.; Tagliani, E.; Cirillo, D. M.; Marchese, V.; Matteelli, A.; Piana, A.; Castellotti, P.; Ferrarese, M.; Gualano, G.; Palmieri, F.; Girardi, E.; Codecasa, L.; Sotgiu, G.. - In: INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE. - ISSN 1027-3719. - 25:5(2021), pp. 395-399. [10.5588/ijtld.21.0036]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11388/246836
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