< Back to previous page

Publication

Short-course regimen for multidrug-resistant tuberculosis: a decade of evidence

Journal Contribution - Journal Article

About ten years ago, the first results of the so-called "Bangladesh regimen", a short regimen lasting nine months instead of 20 months, revolutionized multidrug-resistant tuberculosis (MDR-TB) treatment. Similar short regimens were studied in different settings, relying for their efficacy on a later generation fluoroquinolone, either gatifloxacin, moxifloxacin, or levofloxacin. We review the published material on short MDR-TB regimens, describe their different compositions, their results in national tuberculosis programs in middle- and low-income countries, the risk of acquiring resistance to fluoroquinolone, and the occurrence of adverse events. With over 80% success, the regimen performs much better than longer regimens (usually around 50%). Monitoring of adverse events allows adapting its composition to prevent severe adverse events such as deafness. We discuss the current applicability and usefulness of the short injectable-containing regimen given the 2019 recommendation of the World Health Organization (WHO) for a new long all-oral regimen. We conclude that the most effective fluoroquinolone is gatifloxacin, currently not listed as an essential medicine by WHO. It is a priority to restore its status as an essential medicine.

Journal: Journal of Clinical Medicine
Issue: 1
Volume: 9
Number of pages: 12
Publication year:2020
Keywords:tuberculosis, treatment, MDR, 9-month regimen, outcome analysis, fluoroquinolones, MDR-TB PATIENTS, MYCOBACTERIUM-TUBERCULOSIS, TREATMENT OUTCOMES, DRUG-RESISTANCE, GATIFLOXACIN, MOXIFLOXACIN, INFECTION, THERAPY