Outcomes of bedaquiline-containing regimen in the treatment of adults with drug-resistant tuberculosis in a tertiary care center in Rajasthan

Monaldi Arch Chest Dis. 2023 Aug 7;94(2). doi: 10.4081/monaldi.2023.2618.

Abstract

The emergence of drug-resistant strains of Mycobacterium tuberculosis has become a significant public health problem and has led to a setback in the efforts to end tuberculosis (TB) worldwide. The longer duration, heavier pill load, and higher toxicity profile of drug-resistant TB regimens compared to those for drug-susceptible TB lead to reduced adherence and worse treatment results, including mortality. This study was conducted to estimate treatment outcomes and adverse effects in patients with drug-resistant TB on a bedaquiline-containing regimen. Patients after the pre-treatment evaluation were enrolled in a bedaquiline-containing regimen. These patients were followed up for 18 months, and the final outcome was assessed along with the adverse effects. It was found that 49 (84.4%) patients achieved culture conversion by 3 months, 54 (93.1%) achieved culture conversion by 6 months, 52 (83.81%) had favorable outcomes (cured, treatment completed), and 10 had unfavorable outcomes (died, lost to follow-up, failed). Coupled with gradually increasing trends in success rates since 2012, lesser failure rates and fewer concerns regarding grave adverse effects are a silver lining in the cloud of increasing burden and widening resistance patterns. More funding has to be directed towards ensuring adherence and finding high-risk individuals to expedite the achievement of sustainable development goals.

MeSH terms

  • Adult
  • Antitubercular Agents* / administration & dosage
  • Antitubercular Agents* / adverse effects
  • Antitubercular Agents* / therapeutic use
  • Diarylquinolines* / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Humans
  • India / epidemiology
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / isolation & purification
  • Tertiary Care Centers*
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant* / drug therapy
  • Young Adult

Substances

  • bedaquiline
  • Diarylquinolines
  • Antitubercular Agents