More research needed on the best treatment options for multidrug-resistant TB

The use of newer drugs, a greater number of effective drugs, and a longer treatment regimen may be associated with improved survival of patients with multidrug resistant tuberculosis (MDR-TR), according to a large study by a team of international researchers published in this week's PLOS Medicine.

Global efforts to control tuberculosis are being challenged by the emergence of strains that are resistant to several antibiotics including isoniazid and rifampicin, the two most powerful, first-line (standard) anti-tuberculosis drugs—so-called multidrug (MDR-TB). The treatment of MDR-TB is lengthy, toxic, expensive, and has mostly resulted in poor outcomes for patients. Importantly, the optimal treatment regimens for MDR-TB have not been determined and, to date, there have been no of treatments for MDR-TB.

In this study, a large group of international researchers (the Collaborative Group for Meta-Analysis of Individual in MDR-TB) combined data on outcomes of 9153 patients from 32 centers to find out more about the best way of treating MDR-TB. The researchers found that the use of certain drugs, the use of four or more effective drugs, and the duration of treatment were associated with successful .

The authors conclude: "This individual patient data meta-analysis of 9,153 patients suggests that of MDR-TB should include a later generation quinolone, and ethionamide or prothionamide. In patients who have not received second-line drugs before, the optimal number of likely effective drugs appears to be at least four in the initial intensive phase, and at least three in the continuation phase. The duration of therapy associated with highest odds of success was 7-8.5 months for the initial intensive phase, and 25-27 months for total duration."

However, these findings should be interpreted with caution because of the limitations in the methods and type of data used in the study. The authors say: "In view of the serious limitations of these observational data, these findings should be considered to have highlighted several important questions for future clinical trials.

These questions include the role and choice of injectables (medications that have to be given by injection), the optimal duration of an injectable and total therapy, and the potential value of later generation quinolones as well as certain group 4 and group 5 drugs."

More information: Ahuja SD, Ashkin D, Avendano M, Banerjee R, Bauer M, et al. (2012) Multidrug Resistant Pulmonary Tuberculosis Treatment Regimens and Patient Outcomes: An Individual Patient Data Meta-analysis of 9,153 Patients. PLoS Med 9(8): e1001300. doi:10.1371/journal.pmed.1001300

add to favorites email to friend print save as pdf

Related Stories

Drug-resistant tuberculosis rife in China

Dec 11, 2008

Levels of drug-resistant tuberculosis (TB) in China are nearly twice the global average. Nationwide research published in the open access journal BMC Infectious Diseases has shown that almost 10% of Chinese TB cases are re ...

Recommended for you

Ebola kills 31 people in DR Congo: WHO

51 minutes ago

An outbreak of the Ebola virus in the Democratic Republic of Congo has killed 31 people and the epidemic remains contained in a remote northwestern region, UN the World Health Organization (WHO) said Tuesday.

Dengue fever strikes models in Japan

3 hours ago

A worsening outbreak of dengue fever in Japan has claimed its first celebrities—two young models sent on assignment to the Tokyo park believed to be its source.

Japanese researchers develop 30-minute Ebola test

3 hours ago

Japanese researchers said Tuesday they had developed a new method to detect the presence of the Ebola virus in 30 minutes, with technology that could allow doctors to quickly diagnose infection.

Senegal monitors contacts of 1st Ebola patient

15 hours ago

Senegalese authorities on Monday were monitoring everyone who was in contact with a student infected with Ebola who crossed into the country, and who has lost three family members to the disease.

Cerebral palsy may be hereditary

21 hours ago

Cerebral palsy is a neurological developmental disorder which follows an injury to the immature brain before, during or after birth. The resulting condition affects the child's ability to move and in some ...

User comments