First use of bedaquiline in a patient with XDR-TB in Singapore

Drug-resistant tuberculosis (TB) continues to pose a threat to global control of TB: 3.5% of new and 20.5% of previously treated TB cases were estimated to have multidrug-resistant (MDR)-TB in 2013. Approximately 9% of patients with MDR-TB had extensively drug-resistant (XDR)-TB. A 30-year-old Vietn...

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Bibliographic Details
Published in:BMJ case reports 2015-09, Vol.2015, p.bcr2015210961
Main Authors: Chua, Angeline Poh-Gek, Hoo, Grace Si-Ru, Chee, Cynthia Bin-Eng, Wang, Yee Tang
Format: Article
Language:English
Subjects:
Adult
Antitubercular Agents - therapeutic use
Asia
Diarylquinolines - therapeutic use
Drug resistance
Extensively Drug-Resistant Tuberculosis - drug therapy
Female
Fistula
Global Health
Humans
Mutation
Mycobacterium tuberculosis - genetics
Other Asian
Radiography, Thoracic
Singapore
Thorax
Tomography, X-Ray Computed
Tuberculosis
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Summary:Drug-resistant tuberculosis (TB) continues to pose a threat to global control of TB: 3.5% of new and 20.5% of previously treated TB cases were estimated to have multidrug-resistant (MDR)-TB in 2013. Approximately 9% of patients with MDR-TB had extensively drug-resistant (XDR)-TB. A 30-year-old Vietnamese woman previously treated for TB in her home country presented with 5 months of cough and shortness of breath 1 year after migrating to Singapore. Xpert MTB/Rif testing showed rpoB gene mutation. Phenotypic drug susceptibility testing revealed XDR-TB. Second and third-line TB drugs were commenced. To strengthen the efficacy of her treatment regimen, the novel anti-TB drug bedaquiline was obtained for the patient on compassionate grounds. We report the first use in Singapore of bedaquiline for the treatment of XDR-TB.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2015-210961