Brief update on the use of Bedaquiline in adolescents.
This week we suggest to read "Brief update on the use of Bedaquiline in adolescents", an article published on Sentinel.project.org in April 2017.
On March 13, 2017, the World Health Organization issued a meeting report that included evidence on the use of bedaquiline in 537 individuals treated for MDR-TB disease, including adolescents. In light of this new data, a group of clinical experts from the Sentinel Project developed a brief update on bedaquiline, with recommendations to clinical providers and national TB programs.
AUTHORS: Jennifer Furin, James Seddon, Giovanni B. Migliori, Lia D’Ambrosio, Marina Tadolini, Ben Marais, Jay Achar, Andrea Cruz, Stephen Graham, Sylvie Jonckheere, Lindsay McKenna, Alena Skrahina, Peyton Wilson, H. Simon Schaaf
Read more here.
Proposal for a standardised treatment of pre- and extensively drug-resistant TB cases.
This week WAidid suggests to read an article entitled "Proposal for a standardised treatment regimen to manage pre- and extensively drug-resistant tuberculosis cases", published on The European Respiratory Journal in 2017.
The World Health Organization reports that the number of patients suffering from TB with resistance to rifampicin (RR-TB), or multidrug-resistant TB increases alarmingly each year.
The treatment success rates achieved globally are sub-optimal, barely exceeding 50%. A proportion decreasing to 25% in patients with XDR-TB and to <20% when the drug resistance profile is beyond XDR. The outcomes observed suggest that specific patients achieve treatment success, the impact on the RR-/MDR-TB epidemic being rather limited.
WHO has recently recommended the so called ‘shorter regimens’ (9-12 months) for patients with RR-/MDR-TB who are susceptible to FQs and SLIs, or who have not previously received these two groups of drugs. These ‘shorter regimens’ have achieved relapse-free success rates on 85-90% of the MDR-TB patients treated. While an impact on the MDR-TB epidemic is forecasted by scaling-up the use of these regimens, this does not work automatically for XDR- or pre-XDR-TB cases.
The aim of this article is to discuss the possibility of designing a standardised regimen which, ideally supported by the use of rapid diagnostic methods to identify eligible patients, would be potentially effective in the majority of cases affected by pre-XDR- and XDR-TB. However, even without access to these rapid diagnostic methods, or waiting for their results, this regimen could work in patients failing the shorter or conventional standardized MDR-TB regimens. Therefore, the target of this regimen would be most of the patients with pre-XDR- and XDR-TB. This regimen would complement the existing set of available standard regimens for new cases and MDR-TB cases (the WHO-recommended ‘shorter’ regimen).
AUTHORS: Jose A. Caminero, Alberto Piubello, Anna Scardigli and Giovanni Battista Migliori.
Read the full article here: erj.ersjournals.com/content/50/1/1700648