Short-course regimen for multidrug-resistant tuberculosis: a decade of evidence

Arnaud Trebucq, Tom Decroo, Armand Van Deun, Alberto Piubello, Chen-Yuan Chiang, Kobto G. Koura, Valerie Schwoebel

Research output: Contribution to journalA1: Web of Science-article

Abstract

About ten years ago, the first results of the so-called "Bangladesh regimen", a short regimen lasting nine months instead of 20 months, revolutionized multidrug-resistant tuberculosis (MDR-TB) treatment. Similar short regimens were studied in different settings, relying for their efficacy on a later generation fluoroquinolone, either gatifloxacin, moxifloxacin, or levofloxacin. We review the published material on short MDR-TB regimens, describe their different compositions, their results in national tuberculosis programs in middle- and low-income countries, the risk of acquiring resistance to fluoroquinolone, and the occurrence of adverse events. With over 80% success, the regimen performs much better than longer regimens (usually around 50%). Monitoring of adverse events allows adapting its composition to prevent severe adverse events such as deafness. We discuss the current applicability and usefulness of the short injectable-containing regimen given the 2019 recommendation of the World Health Organization (WHO) for a new long all-oral regimen. We conclude that the most effective fluoroquinolone is gatifloxacin, currently not listed as an essential medicine by WHO. It is a priority to restore its status as an essential medicine.

Original languageEnglish
Article number55
JournalJournal of Clinical Medicine
Volume9
Issue number1
Number of pages12
DOIs
Publication statusPublished - 2020

Keywords

  • tuberculosis
  • treatment
  • MDR
  • 9-month regimen
  • outcome analysis
  • fluoroquinolones
  • MDR-TB PATIENTS
  • MYCOBACTERIUM-TUBERCULOSIS
  • TREATMENT OUTCOMES
  • DRUG-RESISTANCE
  • GATIFLOXACIN
  • MOXIFLOXACIN
  • INFECTION
  • THERAPY

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