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Review

Short-Course Regimen for Multidrug-Resistant Tuberculosis: A Decade of Evidence

1
International Union Against Tuberculosis and Lung Disease, 75006 Paris, France
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Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
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Research Foundation Flanders, 1000 Brussels, Belgium
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Mycobacteriology Unit, Institute of Tropical Medicine, 2000 Antwerp, Belgium
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Damien Foundation, POBox 1065, Niamey, Niger
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Division of Pulmonary Medicine, Department of Internal Medicine, Wanfang Hospital, Taipei Medical University, Taipei 11696, Taiwan
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Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
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COMUE Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, 75006 Paris, France
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École Nationale de Formation des Techniciens Supérieurs en Santé Publique et en Surveillance Epidémiologique, Université de Parakou, Parakou, Benin
*
Author to whom correspondence should be addressed.
Received: 20 November 2019 / Revised: 11 December 2019 / Accepted: 13 December 2019 / Published: 25 December 2019
(This article belongs to the Special Issue Tuberculosis: Clinical Applications in the Diagnosis and Treatment)
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. View Full-Text
Keywords: tuberculosis; treatment; MDR; 9-month regimen; outcome analysis; fluoroquinolones tuberculosis; treatment; MDR; 9-month regimen; outcome analysis; fluoroquinolones
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MDPI and ACS Style

Trébucq, A.; Decroo, T.; Van Deun, A.; Piubello, A.; Chiang, C.-Y.; Koura, K.G.; Schwoebel, V. Short-Course Regimen for Multidrug-Resistant Tuberculosis: A Decade of Evidence. J. Clin. Med. 2020, 9, 55. https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9010055

AMA Style

Trébucq A, Decroo T, Van Deun A, Piubello A, Chiang C-Y, Koura KG, Schwoebel V. Short-Course Regimen for Multidrug-Resistant Tuberculosis: A Decade of Evidence. Journal of Clinical Medicine. 2020; 9(1):55. https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9010055

Chicago/Turabian Style

Trébucq, Arnaud, Tom Decroo, Armand Van Deun, Alberto Piubello, Chen-Yuan Chiang, Kobto G. Koura, and Valérie Schwoebel. 2020. "Short-Course Regimen for Multidrug-Resistant Tuberculosis: A Decade of Evidence" Journal of Clinical Medicine 9, no. 1: 55. https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9010055

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