药物建议,以优化MDR/RR-TB治疗结果,基于多中心,大规模,中国的回顾性队列研究
Lin Fan1, Ming Yang2, Yu-Tong Han3,4
1Department of Tuberculosis, Shanghai Clinical Research Center for Tuberculosis, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai Clinical Research Center for Tuberculosis, Shanghai Key Lab of Tuberculosis, Shanghai, China.
Expert review of anti-infective therapy
|January 22, 2024
概括
这项研究建议Bedaquiline,Linezolid和Cycloserin用于治疗多药耐药结核病 (MDR/RR-TB). 由于不良结果的增加,不建议注射Capreomycin等药物.
科学领域:
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 药物耐药性模式的变化需要更新针对多药耐药/瑞辛耐药结核病 (MDR/RR-TB) 的治疗方案.
- 优化药物选择对于改善MDR/RR-TB治疗患者的治疗结果至关重要.
研究的目的:
- 为MDR/RR-TB治疗中药物选择提供基于证据的建议.
- 评估特定药物使用与治疗结果在大量患者队列中的关联.
主要方法:
- 这是一项多中心的回顾性研究,涉及3112名在2018-2021年期间接受治疗的患者.
- 使用多变量和倾向得分匹配的逻辑回归分析.
- 评估治疗结果,包括成功,失败,失去随访和死亡率.
主要成果:
- 治疗成功率为74.29%;死亡率为1.51% .
- 贝达基林 (Bdq),线索利德 (Lzd) 和环素 (Cs) 与治疗成功积极相关.
- 卡普雷奥米辛 (Cm) 增加了不良结果的风险,而阿米卡辛 (Amk) 和克洛法齐明没有显著的影响.
- 诺基诺 (FQs) 的使用降低了当分离物敏感时不良结果的风险.
结论:
- 针对MDR/RR-TB的推治疗顺序:贝达基林,线索利德和环素.
- 减少了化类的使用.
- 由于不良结果的关联,不建议注射药物 (阿米卡辛,卡普雷奥米辛).
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