Results of treatment of drug-resistant tuberculosis of mycobacteria using bedaquiline and delamanid

Abstract

The article presents the results of an analysis of the efficacy and safety of bedaquiline and delamanid in patients with multidrug-resistant tuberculosis (MDR-TB). We studied 73 patients with MDR-TB of the lungs who received treatment with bedaquiline and / or delamanid for> 4 weeks in combination with a background regimen recommended by the WHO. For all patients, the treatment regimen was selected individually, according to the drug sensitivity test. The average age of patients was 49.1 ± 2.77 years, men were 46 (63.0%), women — 27 (37.0%). The patients were divided into 3 groups: Group I — 28 patients who were included in the treatment regimen with bedaquiline, Group II — 25 patients who were included in the treatment regimen with delamanid, Group III — 20 patients were treated with both drugs. A month after treatment, the amount of hemoglobin in comparison with the initial value in group I increased by an average of 29.5% (p <0.05), in groups II and III by 31.9% (p <0.05) and 31, 4% (p <0.05), respectively. The mean albumin value increased by 13.2%, 14.7% and 20.3% in groups I, II and III, respectively. The concentration of ALT and AST in the blood after treatment decreased, respectively, by 24.0 and 28.2% in group I, by 29.8 and 36.5% (p <0.05) in group II, by 32.0 (p < 0.05) and 39.0% (p <0.05) in group III. Samples of 49 (80.3%), 44 (71.5%) and 28 (45.9%) patients were resistant to ethambutol, pyrazinamide, and streptomycin, respectively. Resistant to kanamycin were 30.1% of the samples, to ofloxacin — 68.5%. in 58.9% of cases, sputum cultures were positive at the time of initiation of treatment with bedaquiline and / or delamanid. Of these, 39.7% have achieved culture conversion. Adverse reactions were observed in 43.8% of patients. The inclusion of bedaquiline and delamanid in the anti-tuberculosis therapy regimen promotes clinical improvement and a decrease in bacterial excretion in a fairly short time. Treatment of MDR-TB patients with bedaquiline and/or delamanid was effective and well tolerated.