SETTING: Although modern tuberculosis treatment relies on chemotherapy, surgery is accepted as adjuvant treatment for multidrug-resistant tuberculosis (MDR-TB). OBJECTIVE: To evaluate the effect of resectional surgery and fluoroquinolones on long-term treatment success and survival in a large group of MDR-TB cases. DESIGN: A total of 252 patients with MDR-TB were included in this retrospective cohort study. Multiple logistic regression was used to determine independent predictive factors for long-term treatment success, and survival analyses were done based on different treatment approaches with or without surgery. RESULTS: The mean age of the study cohort was 37.9 +/- 12.5 years; 204 (80%) were males. Long-term treatment success was associated with resistance to fewer drugs, female sex, younger age and limited disease. Sixty-six patients (26.2%) had undergone resectional surgery after 2-16 months of treatment. The highest long-term treatment success and survival rates were achieved in patients who both received fluoroquinolones and underwent surgery (P = 0.001 vs. other groups). CONCLUSION: Although the treatment success rate was higher in patients treated with surgery and fluoroquinolones compared to other groups, an additional significant benefit from surgery could not be demonstrated. Larger scale studies are needed to clarify this issue.
SETTING: Although modern tuberculosis treatment relies on chemotherapy, surgery is accepted as adjuvant treatment for multidrug-resistant tuberculosis (MDR-TB). OBJECTIVE: To evaluate the effect of resectional surgery and fluoroquinolones on long-term treatment success and survival in a large group of MDR-TB cases. DESIGN: A total of 252 patients with MDR-TB were included in this retrospective cohort study. Multiple logistic regression was used to determine independent predictive factors for long-term treatment success, and survival analyses were done based on different treatment approaches with or without surgery. RESULTS: The mean age of the study cohort was 37.9 +/- 12.5 years; 204 (80%) were males. Long-term treatment success was associated with resistance to fewer drugs, female sex, younger age and limited disease. Sixty-six patients (26.2%) had undergone resectional surgery after 2-16 months of treatment. The highest long-term treatment success and survival rates were achieved in patients who both received fluoroquinolones and underwent surgery (P = 0.001 vs. other groups). CONCLUSION: Although the treatment success rate was higher in patients treated with surgery and fluoroquinolones compared to other groups, an additional significant benefit from surgery could not be demonstrated. Larger scale studies are needed to clarify this issue.
Authors: Russell R Kempker; Aline B Barth; Sergo Vashakidze; Ketino Nikolaishvili; Irina Sabulua; Nestani Tukvadze; Nino Bablishvili; Shota Gogishvili; Ravi Shankar P Singh; Jeannette Guarner; Hartmut Derendorf; Charles A Peloquin; Henry M Blumberg Journal: Antimicrob Agents Chemother Date: 2015-03-16 Impact factor: 5.191
Authors: Rebecca C Harris; Mishal S Khan; Laura J Martin; Victoria Allen; David A J Moore; Katherine Fielding; Louis Grandjean Journal: BMC Infect Dis Date: 2016-06-10 Impact factor: 3.090
Authors: Lin Wang; Fan Xia; Feng Li; Xueqin Qian; Yijun Zhu; Hui Chen; Aoao Bian; Jun Wang; Min Zhang; Hongwei Li; Jiafu Han; Nan Jiang; Ning Xu; Yanzheng Song Journal: Medicine (Baltimore) Date: 2017-12 Impact factor: 1.817