MDRTB, 七個藥前四個月，三個藥後五個月, 花不多錢!

NEW YORK (Reuters Health) Jun 01 - A regimen employing a fluoroquinolone, kanamycin and prothionamide as core agents is highly effective against multidrug resistant tuberculosis (TB), researchers reported online May 4th in the American Journal of Respiratory and Critical Care Information.

"One could say that the treatment regimen we developed is revolutionary," Dr. Armand Van Deun told Reuters Health by e-mail. "It has less potentially toxic second-line drugs, and it is fully comparable with the classical first-line drug regimens for non-resistant tuberculosis in its relatively short duration and high effectiveness."

And "because all medications were generic preparations, the regimen cost just above 200 Euros (about US$245), making it a promising approach for many low-income countries," according to the researchers.

In an observational study of Bangladeshi patients between 1997 and 2007, Dr. Van Deun of the International Union Against Tuberculosis and Lung Disease, Paris, and colleagues analyzed the outcome of various regimens in 427 patients with multidrug-resistant TB.

The team found that the most effective treatment regimen required a minimum of nine months of gatifloxacin, clofazimine, ethambutol, and pyrazinamide throughout, supplemented by prothionamide, kanamycin, and high-dose isoniazid during an intensive phase of a minimum of four months.

In the 206 patients who received this regimen, the relapse-free cure rate was 87.9%. Major adverse drug reactions were infrequent and manageable.

Compared to the 221 patients treated with regimens based on ofloxacin and generally prothionamide throughout, the hazard ratio for any adverse outcome was 0.39.

The researchers observe that by World Health Organization estimates, 0.5 million new cases of tuberculosis resistant to isoniazid and rifampin emerged globally in 2007.

Use of this standardized regimen, with its "relatively low cost and insensitivity to the most common types of second-line drug resistance," means that "treatment of multidrug resistant tuberculosis now becomes far more easily and widely accessible, particularly for the countries with least resources," Dr. Van Deun concluded.

http://ajrccm.atsjournals.org/cgi/content/abstract/201001-0077OCv1

RELAPSE RATE 小於15%，看來不錯…

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