This article provides hope that XDR TB cases can be treated successfully.
60.4% success is a great result.
However, in Tomsk we treated successfully only 48.3% XDR TB cases as
compared to 63.2% of non-XDR TB cases. Maybe we should compare Peruvian and
Tomsk XDR TB cohorts regarding any differences in resistance patterns and
other important determinants of failure/success. If both cohorts are
comparable, then we can make some recommendations for Tomsk (or maybe for
other sites as well). I can see that Tomsk didn't use moxifloxacin as often
as it was done in Peru due to its limited availability; the rate of surgery
is sligthly lower too.
Link leads to: http://content.nejm.org/cgi/content/full/359/6/563?query=TOC
Summary: This new article published in this week’s New England Journal of Medicine available in full text offers a description of the management of extensively drug-resistant tuberculosis and treatment outcomes among patients who were referred for individualized outpatient therapy in Peru.
Isolates from 651 patients were tested for XDR TB and regimens that included five or more drugs to which the infecting isolate was not resistant were developed.
In conclusion, this piece shows that XDR TB can be cured in HIV-negative patients through outpatient treatment, even in those who have received multiple prior courses of therapy for TB.
Also take a look at the editorial by the Director of WHO's Stop TB Department, Dr. Mario Raviglione: Facing Extensively Drug-Resistant Tuberculosis — A Hope and a Challenge (http://content.nejm.org/cgi/content/full/359/6/636).
Source: New England Journal of Medicine - NEJM
Publication Date: August 7, 2008
Keywords: peru, Publications & Research