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Demonstrating a Multi-drug Resistant Mycobacterium tuberculosis Amplification Microarray
Published on: April 25, 2014
[EXPERIENCE OF USE OF NEW ANTI-TUBERCULOUS DRUG, DELAMANID IN MULTI- AND EXTENSIVELY DRUG RESISTANT TUBERCULOSIS
Abstract:
[Objective] We experienced use of new anti- tuberculous drug, Delamanid in multi- and extensively drug resistant tuberculosis (M (X) DR-TB) in our hospital. [Materials and Methods] Fifteen cases who were diagnosed M(X)DR-TB had been used Delamanid in our hospital from 2014 to 2015. [Results] The gender distribution consisted of eleven males and four females in M(X)DR-TB. The mean age was 53.3 years old in male and 28.3 years old in female. Japanese were eight cases, and Chinese were five cases, and other countries patients were two cases. Twelve cases were MDR-TB cases, and three cases were XDR-TB cases. Six cases of fifteen cases were sputum culture positive before using Delamanid. Two cases (13.3%) had been appearanced QTc extension in EKG by using Delamanid. But these cases had not seen symptom. Other typical side effects had not seen. Six cases (40.0%) of fifteen cases had done surgical resection. One case of fifteen cases had been died with intractable pneumothorax, and one case had been discontinued for leukopenia. All cases containing two discontinued cases had obtained negative conversion of sputum culture. [Conclusion] We experienced new anti-tuberculous drug, Delamanid. If we add Delamanid only for MDR-TB patients with only one or two sensitive anti-tuberculous drugs, it will be possible to make anew resistance. We used one more another new drug, for example Linezolid or high dose isoniazid or Meropenem and Ampicilin Clavulanate acid with Delamanid and sensitive anti-tuberculous drugs. We need to investigate risk and benefit when we use new anti-tuberculous drug. We need not to make more another MDR-TB cases.
Insights
Delamanid shows promise in treating multi- and extensively drug-resistant tuberculosis (M(X)DR-TB), with all patients achieving negative sputum cultures. Careful drug combination is crucial to prevent new resistance developing.
Area of Science:
- Medical Research
- Pharmacology
- Infectious Diseases
Background:
- Multi- and extensively drug-resistant tuberculosis (M(X)DR-TB) presents significant treatment challenges.
- Novel therapeutic agents are critical for managing drug-resistant tuberculosis.
- Delamanid is a newer drug investigated for its efficacy in M(X)DR-TB.
Purpose of the Study:
- To evaluate the clinical experience of using Delamanid in patients with M(X)DR-TB.
- To assess the safety and effectiveness of Delamanid in a real-world hospital setting.
- To identify potential risks and benefits associated with Delamanid treatment.
Main Methods:
- A retrospective analysis of fifteen M(X)DR-TB patients treated with Delamanid between 2014 and 2015.
- Data collection included patient demographics, TB resistance profiles, treatment outcomes, and adverse events.
- Sputum culture conversion and electrocardiogram (EKG) findings (QTc interval) were primary outcome measures.
Main Results:
- Eleven males and four females, with a mean age of 53.3 (males) and 28.3 (females), were included.
- Twelve cases were multidrug-resistant tuberculosis (MDR-TB) and three were extensively drug-resistant tuberculosis (XDR-TB).
- Two patients (13.3%) experienced asymptomatic QTc interval prolongation; no other significant side effects were noted. All fifteen patients achieved negative sputum culture conversion, including two who discontinued treatment due to leukopenia or pneumothorax.
Conclusions:
- Delamanid was successfully used in M(X)DR-TB patients, with all achieving sputum culture conversion.
- Caution is advised when using Delamanid with limited sensitive drugs to prevent acquired resistance.
- Combination therapy, potentially including drugs like Linezolid, high-dose isoniazid, or Meropenem/Ampicilin Clavulanate, alongside Delamanid and sensitive agents, warrants further investigation to optimize M(X)DR-TB management and prevent further resistance.
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