Abstract
The objective: to evaluate the efficiency of chemotherapy with bedaquiline in pulmonary tuberculosis patients with multiple drug resistance Subjects and methods. The chemotherapy efficiency was studied in 70 tuberculosis patients with extensive (XDR) or multiple (MDR) drug resistance who were treated in clinics of Central Tuberculosis Research Institute All patients were divided into 3 groups: Group 1 (10 persons) included MDR TB patients, Group 2 (32 persons) included pre-XDR TB patients, Group 3 (28 persons) included XDR TB patients Results of the study. High treatment efficiency in this difficult category of pulmonary tuberculosis patients with MDR and XDR was achieved when bedaquiline was added to the chemotherapy regimen Upon the completion of the main treatment course with bedaquiline, in the group of patients with MDR and pre-XDR the sputum conversion was achieved in 100%, and in XDR tuberculosis patients the sputum conversion rate made 893% The long-term treatment course with bedaquiline promoted the fastest sputum conversion, healing of cavities in the lungs of patients with disseminated tuberculosis and XDR, and it was not associated with a higher frequency of adverse events
Highlights
Цель: оценка эффективности химиотерапии с использованием бедаквилина у больных туберкулезом легких, выделяющих микобактерии туберкулеза (МБТ) с множественной лекарственной устойчивостью
The chemotherapy efficiency was studied in 70 tuberculosis patients with extensive (XDR) or multiple (MDR) drug resistance who were treated in clinics of Central Tuberculosis Research Institute
All patients were divided into 3 groups: Group 1 (10 persons) included MDR TB patients, Group 2 (32 persons) included pre-XDR TB patients, Group 3 (28 persons) included XDR TB patients
Summary
В ходе проспективного исследования изучена эффективность химиотерапии у 70 больных, проходивших лечение в ЦНИИТ в 2009-2016 гг. Критерии включения: возраст более 18 лет, ВИЧ-отрицательный статус, наличие бактериовыделения, определяемого методом микроскопии и посева, ШЛУ или МЛУ возбудителя, приверженность к лечению. Критерии исключения: несоответствие критериям включения, внеторакальные локализации туберкулеза, тяжелая сопутствующая декомпенсированная патология. Эффективность химиотерапии оценивали по микробиологическим и рентгенологическим данным. Микробиологическое исследование мокроты на МБТ (люминесцентная микроскопия, посев на жидкие питательные среды) проводили ежемесячно до прекращения бактериовыделения, далее – каждые 2 мес. Динамику регрессии туберкулезного процесса в легких оценивали на 2, 4, 6, 12-м мес. Компьютерную томографию органов грудной клетки (КТ ОГК) проводили при поступлении пациента в стационар, через 6 и 12 мес. Статистическую обработку материала проводили с применением программ Excel и BIOSTAT с использованием χ2-критерия с учетом различий с достоверностью 95% и выше (p < 0,05)
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