Group 5 drugs for multidrug-resistant tuberculosis: Individual patient data meta-analysis

Greg J. Fox, Andrea Benedetti, Helen Cox, Won Jung Koh, Piret Viiklepp, Shama Ahuja, Geoffrey Pasvol, Dick Menzies, S. Ahuja, D. Ashkin, M. Avendaño, R. Banerjee, M. Bauer, M. G. Hollm-Delgado, M. Pai, L. Shah, J. N. Bayona, M. Becerra, M. Burgos, R. CentisL. D'Ambrosio, G. B. Migliori, E. D. Chan, C. Y. Chiang, W. C M De Lange, R. Van Altena, T. S. Van Der Werf, K. De Riemer, N. H. Dung, D. Enarson, D. Falzon, R. M. Granich, K. Flanagan, J. Flood, N. Gandhi, L. Garcia-Garcia, T. H. Holtz, M. Iseman, M. J. Strand, L. G. Jarlsberg, S. Royce, S. Keshavjee, H. R. Kim, C. D. Mitnick, J. Lancaster, M. Van Der Walt, C. Lange, V. Leimane, V. Riekstina, C. C. Leung, J. Li, M. Narita, P. O'Riordan, D. Palmero, S. K. Park, J. Pena, C. Pérez-Guzmán, A. Ponce-De-Leon, J. Sifuentes-Osornio, M. I D Quelapio, T. E. Tupasi, J. Robert, H. S. Schaaf, K. J. Seung, S. S. Shin, T. S. Shim, Y. Shiraishi, G. Sotgiu, P. Tabarsi, M. H. Vargas, J. Westenhouse, W. W. Yew, J. J. Yim

研究成果: 雜誌貢獻文章

14 引文 斯高帕斯(Scopus)

摘要

The role of so-called "group 5" second-line drugs as a part of antibiotic therapy for multidrug-resistant tuberculosis (MDR-TB) is widely debated. We performed an individual patient data meta-analysis to evaluate the effectiveness of several group 5 drugs including amoxicillin/clavulanic acid, thioacetazone, the macrolide antibiotics, linezolid, clofazimine and terizidone for treatment of patients with MDR-TB. Detailed individual patient data were obtained from 31 published cohort studies of MDR-TB therapy. Pooled treatment outcomes for each group 5 drug were calculated using a random effects meta-analysis. Primary analyses compared treatment success to a combined outcome of failure, relapse or death. Among 9282 included patients, 2191 received at least one group 5 drug. We found no improvement in treatment success among patients taking clofazimine, amoxicillin/clavulanic acid or macrolide antibiotics, despite applying a number of statistical approaches to control confounding. Thioacetazone was associated with increased treatment success (OR 2.6, 95% CI 1.1-6.1) when matched controls were selected from studies in which the group 5 drugs were not used at all, although this result was heavily influenced by a single study. The development of more effective antibiotics to treat drug-resistant TB remains an urgent priority.

原文英語
文章編號1600993
期刊European Respiratory Journal
49
發行號1
DOIs
出版狀態已發佈 - 一月 1 2017

    指紋

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

引用此

Fox, G. J., Benedetti, A., Cox, H., Koh, W. J., Viiklepp, P., Ahuja, S., Pasvol, G., Menzies, D., Ahuja, S., Ashkin, D., Avendaño, M., Banerjee, R., Bauer, M., Hollm-Delgado, M. G., Pai, M., Shah, L., Bayona, J. N., Becerra, M., Burgos, M., ... Yim, J. J. (2017). Group 5 drugs for multidrug-resistant tuberculosis: Individual patient data meta-analysis. European Respiratory Journal, 49(1), [1600993]. https://doi.org/10.1183/13993003.00993-2016