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Possibly Resistant Tuberculosis Treatment

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1. Possibly Resistant Tuberculosis Treatment

Possibly Resistant Tuberculosis Treatment Possibly Resistant Tuberculosis Treatment Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Possibly Resistant Tuberculosis Treatment Possibly Resistant Tuberculosis Treatment Aka: Possibly Resistant Tuberculosis Treatment , Possibly Resistant Tb Treatment From Related Chapters II. Indications Resistance >4% in patient's community (HIV) Prior exposure III. Precautions This protocol is from 2003 without available new guidance to use for update as of 2016 review Multi-drug resistance requires expert local opinion for guidance IV. Management Initial: Four drug therapy for 2 months or Subsequent

2018 FP Notebook

2. Multidrug-Resistant Tuberculosis Treatment in North Korea: Is Scale-Up Possible? (PubMed)

Multidrug-Resistant Tuberculosis Treatment in North Korea: Is Scale-Up Possible? Kwonjune Seung and colleagues describe the Eugene Bell Foundation's experience of treating MDR-TB in North Korea.

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2016 PLoS medicine

3. Delamanid (Deltyba) and multidrug-resistant pulmonary tuberculosis. For selected patients, with cardiac monitoring

monitoring and close attention to drug interactions. Full review (4 pages) available for download by subscribers. Abstract Pulmonary tuberculosis due to multidrug-resistant mycobacteria is fatal in about 15% of cases. Delamanid, an antibiotic that targets bacteria of the genus Mycobacterium in vitro, has been authorised in the European Union for the treatment of multidrug-resistant pulmonary tuberculosis, in combination with other antibiotics, when the choice of antituberculosis drugs is limited (...) , particularly because of bacterial resistance. Clinical evaluation of delamanid in multidrug-resistant tuberculosis is mainly based on a randomised, double-blind, placebo-controlled trial in 481 patients who also received optimised antituberculosis therapy. The results are undermined by various methodological issues. After 2 months of treatment, 42% of patients in the delamanid 400 mg/day group, 45% of those in the delamanid 200 mg/day group, and 30% of those in the placebo group had negative sputum

2017 Prescrire

4. PROPOSED GUIDELINES TO MINIMISE MULTI-DRUG RESISTANT TUBERCULOSIS TREATMENT DEFAULT IN A MULTI-DRUG RESISTANT UNIT OF LIMPOPO PROVINCE, SOUTH AFRICA (PubMed)

PROPOSED GUIDELINES TO MINIMISE MULTI-DRUG RESISTANT TUBERCULOSIS TREATMENT DEFAULT IN A MULTI-DRUG RESISTANT UNIT OF LIMPOPO PROVINCE, SOUTH AFRICA The increasing prevalence and incidence of Multi Drug Resistant Tuberculosis (MDR-TB) is as a result of the defaulting of treatment by patients. Worldwide, several factors that contribute to patients defaulting to tuberculosis treatment protocol have been identified. This paper aims to develop guidelines to minimise the defaulting rate of MDR-TB (...) themes. Guidelines were developed to address each factor and give recommendations on possible solutions.The guidelines that were developed concluded that co-operation amongst the Department of Health, health practitioners, patient, and family members can help in preventing the defaulting of treatment.

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2018 African journal of infectious diseases

5. Feasibility of Identifying Household Contacts of Rifampin- and Multidrug-Resistant Tuberculosis Cases at High Risk of Progression to Tuberculosis Disease. (PubMed)

Feasibility of Identifying Household Contacts of Rifampin- and Multidrug-Resistant Tuberculosis Cases at High Risk of Progression to Tuberculosis Disease. We assessed multidrug-resistant tuberculosis (MDR-TB) cases and their household contacts (HHCs) to inform the development of an interventional clinical trial.We conducted a cross-sectional study of adult MDR-TB cases and their HHCs in eight high-TB-burden countries. HHCs underwent symptom screening, chest radiography (CXR), sputum TB (...) bacteriology, TB infection (TBI) testing (tuberculin skin test and interferon gamma release assay) and HIV testing.From October 2015 to April 2016, 1016 HHCs from 284 MDR-TB cases were enrolled. At diagnosis, 69% of MDR-TB cases were acid fast bacilli sputum smear-positive and 43% had cavitary disease; at study entry 35% remained smear-positive after a median MDR-TB treatment duration of 8.8 weeks. Nine HHCs were diagnosed with TB prior to entry and excluded. Of the remaining 1007 HHCs, 41% were male

2019 Clinical Infectious Diseases

6. What are the most efficacious treatment regimens for isoniazid-resistant tuberculosis? A systematic review and network meta-analysis (PubMed)

What are the most efficacious treatment regimens for isoniazid-resistant tuberculosis? A systematic review and network meta-analysis Consensus on the best treatment regimens for patients with isoniazid-resistant TB is limited; global treatment guidelines differ. We undertook a systematic review and meta-analysis using mixed-treatment comparisons methodology to provide an up-to-date summary of randomised controlled trials (RCTs) and relative regimen efficacy.Ovid MEDLINE, the Web of Science (...) resistance (rifampicin-containing regimens using fewer than three effective drugs at 4 months, in which rifampicin was protected by another effective drug at 6 months, and rifampicin was taken for 6 months), extending the duration of rifampicin and increasing the number of effective drugs at 4 months lowered the odds of unfavourable outcomes (treatment failure or the lack of microbiological cure; relapse post-treatment; death due to TB) in a fixed-effects model (OR 0.31 (95% credible interval 0.12-0.81

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2016 EvidenceUpdates

7. Rapid tests for diagnosing drug resistant tuberculosis are accurate and may be cost effective

health risk of tuberculosis. Share your views on the research. Why was this study needed? A 2014 Public Health England report showed that tuberculosis (TB) rates in the UK continue to be among the highest of West European countries. There were 7,892 cases of TB recorded in the UK in 2013, around 12 per 100,000 people. TB that does not respond to two of the standard treatments, called multidrug resistant TB, is becoming more common in the UK. Between 2004 and 2011, the proportion of cases (...) for diagnosing TB resistant to two commonly used TB drugs: rifampicin and isoniazid. Where possible, the accuracy results from different studies were pooled using meta-analysis. The economic evaluation considered 44 different treatment pathways for the different diagnostic strategies examined. These pathways determined which medical treatments and health services people with TB would receive. The cost and health impact of each pathway was estimated in terms of the number of years of good quality life

2018 NIHR Dissemination Centre

8. Rapid tests for diagnosing drug resistant tuberculosis are accurate and may be cost effective

health risk of tuberculosis. Share your views on the research. Why was this study needed? A 2014 Public Health England report showed that tuberculosis (TB) rates in the UK continue to be among the highest of West European countries. There were 7,892 cases of TB recorded in the UK in 2013, around 12 per 100,000 people. TB that does not respond to two of the standard treatments, called multidrug resistant TB, is becoming more common in the UK. Between 2004 and 2011, the proportion of cases (...) for diagnosing TB resistant to two commonly used TB drugs: rifampicin and isoniazid. Where possible, the accuracy results from different studies were pooled using meta-analysis. The economic evaluation considered 44 different treatment pathways for the different diagnostic strategies examined. These pathways determined which medical treatments and health services people with TB would receive. The cost and health impact of each pathway was estimated in terms of the number of years of good quality life

2018 NIHR Dissemination Centre

9. Drug resistance characteristics and cluster analysis of M. tuberculosis in Chinese patients with multiple episodes of anti-tuberculosis treatment. (PubMed)

Drug resistance characteristics and cluster analysis of M. tuberculosis in Chinese patients with multiple episodes of anti-tuberculosis treatment. Tuberculosis (TB) patients with multiple episodes of anti-TB treatment represent an important source of TB transmission, as well as a serious threat to the control of drug resistant TB, due to the high risk of multidrug and extensively drug resistance (MDR/XDR) and elongating infectiousness of this patient group. In this study we analyzed (...) repeatedly treated patients suggest the establishment of M/XDR Mtb in this specific patient population. It highlights the urgent needs of providing DST of both 1st- and 2nd-line drugs before and during the medication in China's MDR-TB control program. Furthermore, the possibility of infection with multiple strains should also be considered to be associated with the drug resistance, which calls for the modification of treatment regimen.

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2016 BMC Infectious Diseases

10. Treatment outcomes for multidrug-resistant tuberculosis under DOTS-Plus: a systematic review and meta-analysis of published studies. (PubMed)

Treatment outcomes for multidrug-resistant tuberculosis under DOTS-Plus: a systematic review and meta-analysis of published studies. Anti-tuberculosis drug resistance is a major public health problem that threatens the progress made in tuberculosis care and control worldwide. Treatment success rates of multidrug-resistant tuberculosis (MDR-TB) is a key issue that cannot be ignored. There is a paucity of evidence that assessed studies on the treatment of MDR-TB, which focus on the effectiveness (...) Health Organization 2015 target of at least 75 to 90%. The high default rate observed by conducting this literature review could possibly explain the spread of the MDR-TB strain in various populations. A better treatment success rate was observed among patients in individualized treatment regimens than in standardized ones. Conducting further individual-based meta-analysis is recommended to identify potential factors for defaulting treatment using large-scale and multi-center studies.

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2017 Infectious diseases of poverty

11. Predictors of unsuccessful interim treatment outcomes of multidrug resistant tuberculosis patients. (PubMed)

Predictors of unsuccessful interim treatment outcomes of multidrug resistant tuberculosis patients. Interim treatment outcomes at 6-months for multidrug-resistant tuberculosis (MDR-TB) treatment are among the most basic performance monitoring and key evaluation indicators in the Stop and End TB strategy of the World Health Organization (WHO). Therefore, this study was conducted to evaluate the interim treatment outcomes of MDR-TB patients in Pakistan.This study was conducted at the Programmatic (...) of interim treatment outcomes, standardized WHO methodology was adopted. Simple logistic regression analysis was used to examine the possible association between the dependent variable (i.e. unsuccessful interim treatment outcome) and selected socio-demographic and clinical variables.A total of 100 drug-resistant TB (DR-TB) patients (all types) were registered during the study period. Out of these, 80 were MDR-TB patients for whom interim results were available. Out of the 80 MDR-TB cases, 48 (60%) were

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2017 BMC Infectious Diseases

12. Adverse Events Associated with Treatment of Multidrug-Resistant Tuberculosis in China: An Ambispective Cohort Study (PubMed)

Adverse Events Associated with Treatment of Multidrug-Resistant Tuberculosis in China: An Ambispective Cohort Study BACKGROUND Adverse events are under-appreciated negative consequences that are significant clinical problems for patients undergoing anti-MDR-TB treatment due to longer duration of treatment and more need for concurrent use of multiple second-line drugs. The aim of this study was to determine the incidence of adverse events and their impact on MDR-TB therapy and treatment outcome (...) , and to identify possible drug-event pairs in China. MATERIAL AND METHODS An ambispective cohort study was conducted based on hospital medical records, which included a retrospective study that enrolled 751 MDR-TB patients receiving standardized regimen between May 2009 and July 2013, and a follow-up investigation of treatment outcome conducted in December 2016 in China. Adverse events were determined according to laboratory results or clinical criteria. Cox's proportional hazards regression models were used

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2017 Medical science monitor : international medical journal of experimental and clinical research

13. Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. (PubMed)

Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. Accurate, rapid detection of tuberculosis (TB) and TB drug resistance is critical for improving patient care and decreasing TB transmission. Xpert® MTB/RIF assay is an automated test that can detect both TB and rifampicin resistance, generally within two hours after starting the test, with minimal hands-on technical time. The World Health Organization (WHO) issued initial recommendations on Xpert® MTB/RIF (...) for extraction of data evaluating Xpert® MTB/RIF against the reference standard. We excluded gastric fluid specimens. The reference standard for TB was culture and for rifampicin resistance was phenotypic culture-based DST.For each study, two review authors independently extracted data using a standardized form. When possible, we extracted data for subgroups by smear and HIV status. We assessed the quality of studies using QUADAS-2 and carried out meta-analyses to estimate pooled sensitivity and specificity

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2014 Cochrane

14. What is resistance? Impact of phenotypic versus molecular drug resistance testing on multi- and extensively drug-resistant tuberculosis therapy. (PubMed)

What is resistance? Impact of phenotypic versus molecular drug resistance testing on multi- and extensively drug-resistant tuberculosis therapy. Rapid and accurate drug susceptibility testing (DST) is essential for the treatment of multi- and extensively drug-resistant tuberculosis (M/XDR-TB). We compared the utility of genotypic DST assays with phenotypic DST (pDST) using Bactec 960 MGIT or Löwenstein-Jensen to construct M/XDR-TB treatment regimens for a cohort of 25 consecutive M/XDR-TB (...) patients and 15 possible anti-TB drugs. Genotypic DST results from Cepheid GeneXpert MTB/RIF (Xpert) and line probe assays (LPAs; Hain GenoType MTBDRplus 2.0 and MTBDRsl 2.0) and whole-genome sequencing (WGS) were translated into individual algorithm-derived treatment regimens for each patient. We further analyzed if discrepancies between the various methods were due to flaws in the genotypic or phenotypic test using MIC results. Compared with pDST, the average agreement in the number of drugs

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2017 Antimicrobial Agents and Chemotherapy

15. Association between HIV infection and multidrug-resistant tuberculosis in Africa and Asia :a systematic review and meta-analysis

Association between HIV infection and multidrug-resistant tuberculosis in Africa and Asia :a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any (...) with data from the latest possible time point (in studies reporting an outcome at multiple time points). We will test the robustness of linear regression of time-to-treatment by performing stratified analysis (treatment pre-ischemia vs during vs post-ischemia). We will assess the effect of our decision to pool all reported scales for histological damage by re-running the analyses using only data from studies using the Jablonski scale. ">Sensitivity Example: For meta-analyses using the mean difference

2019 PROSPERO

16. The association between tuberculosis and the development of insulin resistance in adults with pulmonary tuberculosis in the Western sub-district of the Cape Metropole region, South Africa: a combined cross-sectional, cohort study. (PubMed)

The association between tuberculosis and the development of insulin resistance in adults with pulmonary tuberculosis in the Western sub-district of the Cape Metropole region, South Africa: a combined cross-sectional, cohort study. The existence of a bi-directional relationship between tuberculosis (TB) and insulin resistance (IR)/diabetes has been alluded to in literature. Although diabetes has been linked to increased tuberculosis risk, the relationship between tuberculosis as a causative (...) sensitivity check index (QUICKI)]. A prospective cohort sub-section study was additionally performed on approximately half of the baseline study population, who were followed-up at two and five months whilst on tuberculosis treatment. Summary statistics, correlation co-efficients and appropriate analysis of variance were used to describe and analyse data. Participants were excluded if they presented with other forms of tuberculosis, were HIV-positive, obese or had any pre-disposing IR conditions

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2017 BMC Infectious Diseases

17. Treatment of Drug-Susceptible Tuberculosis: Official ATS/CDC/IDSA Clinical Practice Guidelines

, Development and Evaluation Working Group [1, 2]. 854 ? CID 2016:63 (1 October) ? Nahid et al by guest on December 12, 2016 http://cid.oxfordjournals.org/ Downloaded from patient about tuberculosis and its treatment, including possible adverseeffects[21,22];(2)discussingexpectedoutcomesoftreat- ment,speci?callytheabilitytocurethepatientofthedisease;(3) reviewing methods of adherencesupport and plans forassessing response totherapy; and (4) discussing infectiousness andinfec- tion control measures using (...) DOT rather than SAT for routine treatment of patients with all forms of tuberculosis (conditional recommendation; low certainty in the evidence). RECOMMENDEDTREATMENTREGIMENS The preferred regimen for treating adults with tuberculosis caused by organisms that are not known or suspected to be drug resistant is a regimen consisting of an intensive phase of 2 months of isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), and ethambutol (EMB) followed by a continuation phase of 4 months of INH and RIF

2016 American Thoracic Society

18. Modelling the effect of short-course multidrug-resistant tuberculosis treatment in Karakalpakstan, Uzbekistan. (PubMed)

Modelling the effect of short-course multidrug-resistant tuberculosis treatment in Karakalpakstan, Uzbekistan. Multidrug-resistant tuberculosis (MDR-TB) is a major threat to global TB control. MDR-TB treatment regimens typically have a high pill burden, last 20 months or more and often lead to unsatisfactory outcomes. A 9-11 month regimen with seven antibiotics has shown high success rates among selected MDR-TB patients in different settings and is conditionally recommended by the World Health (...) Organization.We construct a transmission-dynamic model of TB to estimate the likely impact of a shorter MDR-TB regimen when applied in a low HIV prevalence region of Uzbekistan (Karakalpakstan) with high rates of drug resistance, good access to diagnostics and a well-established community-based MDR-TB treatment programme providing treatment to around 400 patients. The model incorporates acquisition of additional drug resistance and incorrect regimen assignment. It is calibrated to local epidemiology and used

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2016 BMC Medicine

19. Infection Control for Drug-Resistant Tuberculosis: Early Diagnosis and Treatment Is the Key. (PubMed)

Infection Control for Drug-Resistant Tuberculosis: Early Diagnosis and Treatment Is the Key. Multidrug-resistant (MDR) tuberculosis, "Ebola with wings," is a significant threat to tuberculosis control efforts. Previous prevailing views that resistance was mainly acquired through poor treatment led to decades of focus on drug-sensitive rather than drug-resistant (DR) tuberculosis, driven by the World Health Organization's directly observed therapy, short course strategy. The paradigm has shifted (...) and tuberculosis drug resistance, followed by rapid initiation of appropriate treatment and adherence support, complemented by universal tuberculosis infection control measures in healthcare facilities. It also requires a second paradigm shift, from the classic infection control hierarchy to a novel, decentralized approach across the continuum from early diagnosis and treatment to community awareness and support. A massive scale-up of rapid diagnosis and treatment is necessary to control the MDR tuberculosis

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2016 Clinical Infectious Diseases

20. Later emergence of acquired drug resistance and its effect on treatment outcome in patients treated with Standard Short-Course Chemotherapy for tuberculosis. (PubMed)

Later emergence of acquired drug resistance and its effect on treatment outcome in patients treated with Standard Short-Course Chemotherapy for tuberculosis. The failure of current Standard Short-Course Chemotherapy (SCC) in new and previously treated cases with tuberculosis (TB) was mainly due to drug resistance development. But little is known on the characteristics of acquired drug resistant TB during SCC and its correlation with SCC failure. The objective of the study is to explore (...) ) with the reference of early acquired drug resistant TB emergence.This study demonstrates that later development of acquired drug resistant TB during SCC is liable to suffer treatment failure and acquired MDR-TB pattern may be one of the possible causes.

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2016 BMC pulmonary medicine

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