Operational Research on the Treatment of Drug-Resistant Tuberculosis: Exciting Results That Need to Be Protected

• Published in: American journal of respiratory and critical care medicine 2021-01, Vol.203 (1), p.11-13
• Main Authors: O'Donnell, Max, Mathema, Barun
• Format: Article
• Language: English
• Subjects: Antimicrobial agents; Diarylquinolines; Drug resistance; Humans; Medical research; Nitroimidazoles; Operations Research; Oxazoles; Prospective Studies; Tuberculosis; Tuberculosis, Multidrug-Resistant - drug therapy
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/rccm.202007-2974ED

Over the past 10 years, the introduction of new antimycobacterial drugs has facilitated the construction of innovative new regimens for the treatment of drug-resistant tuberculosis (DR-TB). This study reports on rates of 6-month sputum TB culture conversion using new treatment regimens in a large multinational DR-TB prospective cohort. In this study, 6-month TB culture conversion was used as the primary outcome, which has been previously used as a surrogate for end-of-treatment outcome in patients with DR-TB treated with older second-line regimens. Strengths of this study include its large sample size, with patients recruited in 17 geographically diverse, low- and middle-income countries, primarily Kazakhstan, Georgia, Bangladesh, and Pakistan, the prospective enrollment of patients, inclusion of HIV-infected and HIV-uninfected patients, and the statistical analyses and operational study design. Because diagnostics and DR-TB treatment and care were provided as per routine practices, study results should be considered generalizable to clinical DR-TB programs in high-burden settings.