Abstract
In 2016, World Health Organization published new guidelines for the treatment of multiple drug resistant tuberculosis (MDR TB), which stated that minimum duration of treatment was 9 months. In the Russian Federation, it is impossible to use short course 9-month treatment for MDR-TB since clofazimine is not registered in this country. The objective of the study : to compare efficacy of short course 9-month treatment of MDR-TB and the standard treatment regimen lasting 18-24 months recommended by the Russian Society of Phthisiologists (ROF). Subjects and methods . 180 MDR TB cases notified in 2015, and 179 MDR TB cases notified in 2016 were enrolled into the trial and treated for 18-24 and 12 months. respectively. Chemotherapy regimens included anti-tuberculosis drugs recommended by the ROF. With a 12-month course of treatment, an injectable drug was used for 4 months and discontinued after culture conversion. Results. The efficacy of the short course chemotherapy reached 81% and was not statistically significantly different from the results of the 18-24-month course of treatment. In the patients treated with short course chemotherapy, treatment interruption made 9.5% versus 13.3% in those treated with standard treatment. There were no statistically significant changes in treatment outcomes of both cohorts of MDR-TB patients. Relapses were registered in 6 MDR TB patients from the cohort treated by the standard regimen.
Highlights
In 2016, World Health Organization published new guidelines for the treatment of multiple drug resistant tuberculosis (MDR TB), which stated that minimum duration of treatment was 9 months
In the Russian Federation, it is impossible to use short course 9-month treatment for MDR-TB since clofazimine is not registered in this country
The objective of the study: to compare efficacy of short course 9-month treatment of MDR-TB and the standard treatment regimen lasting 18-24 months recommended by the Russian Society of Phthisiologists (ROF)
Summary
ИСПОЛЬЗОВАНИЕ УКОРОЧЕННЫХ СХЕМ ЛЕЧЕНИЯ ТУБЕРКУЛЕЗА С МНОЖЕСТВЕННОЙ ЛЕКАРСТВЕННОЙ УСТОЙЧИВОСТЬЮ В АРХАНГЕЛЬСКОЙ, МУРМАНСКОЙ, БЕЛГОРОДСКОЙ ОБЛАСТЯХ. Всемирная организация здравоохранения опубликовала новые рекомендации по лечению туберкулеза с множественной лекарственной устойчивостью (МЛУ-ТБ), в которых минимальный срок терапии составляет 9 мес. А. Использование укороченных схем лечения туберкулеза с множественной лекарственной устойчивостью в Архангельской, Мурманской, Белгородской областях // Туберкулёз и болезни лёгких. Short course treatment regimens for multiple drug resistant tuberculosis in Arkhangelsk, Murmansk and Belgorod Regions. Показатель эффективности лечения туберкулеза с множественной лекарственной устойчивостью (МЛУ-ТБ) в мире в 2017 г. Российские Федеральные клинические рекомендации по диагностике и лечению туберкулеза органов дыхания с множественной и широкой лекарственной устойчивостью возбудителя (2015 г.) устанавливают общую длительность химиотерапии МЛУ-ТБ – 18-24 мес. Длительность интенсивной фазы лечения больных МЛУ-ТБ составляла 4 мес. В Российской Федерации применить короткий режим 9-месячного лечения МЛУ-ТБ невозможно в связи с отсутствием регистрации в стране клофаземина. Цель: сравнить эффективность укороченных до 12 мес. режимов лечения МЛУ-ТБ со стандартным режимом лечения длительностью 18-24 мес., рекомендованным Федеральными клиническими рекомендациями
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