Table 2.
Individualized Regimens Prescribed for 47 Patients with XDR Tuberculosis.*
| Regimen | Value |
|---|---|
| Characteristics | |
| Duration of treatment — mo | |
| Median | 24.9 |
| Interquartile range | 13.3–29.0 |
| Duration of treatment with injectable agents — mo | |
| Median | 15.4 |
| Interquartile range | 11.4–19.7 |
| No. of drugs in regimen (no. without documented resistance or prior exposure for >1 mo) | |
| Among all available agents | 5.3±1.3 |
| Among 12 agents or classes for which routine DST was performed† | 3.2±1.2 |
| Drugs included | |
| First-line oral agents | |
| Ethambutol | |
| No. of patients — % | 7 (14.9) |
| Duration of treatment (mo) — median (interquartile range) | 24.4 (14.0–28.6) |
| Pyrazinamide | |
| No. — % | 16 (34.0) |
| Duration of treatment (mo) — median (interquartile range) | 24.7 (10.0–26.4) |
| First-line injectable agent | |
| Streptomycin | |
| No. of patients — % | 18 (38.3) |
| Duration of treatment (mo) — median (interquartile range) | 19.1 (13.0–25.1) |
| Second-line injectable agents | |
| Amikacin | |
| No. of patients — % | 9 (19.1) |
| Duration of treatment (mo) — median (interquartile range) | 14.5 (8.8–18.1) |
| Capreomycin | |
| No. of patients — % | 25 (53.2) |
| Duration of treatment (mo) — median (interquartile range) | 12.5 (8.8–18.5) |
| Kanamycin | |
| No. of patients — % | 8 (17.0) |
| Duration of treatment (mo) — median (interquartile range) | 9.0 (3.6–13.0) |
| First-generation fluoroquinolones | |
| Ciprofloxacin | |
| No. of patients — % | 10 (21.3) |
| Duration of treatment (mo) — median (interquartile range) | 8.0 (4.2–9.9) |
| Ofloxacin | |
| No. of patients — % | 6 (12.8) |
| Duration of treatment (mo) — median (interquartile range) | 9.9 (6.3–13.7) |
| Later-generation fluoroquinolones | |
| Levofloxacin | |
| No. of patients — % | 20 (42.6) |
| Duration of treatment (mo) — median (interquartile range) | 12.1 (7.4–23.0) |
| Sparfloxacin | |
| No. of patients — % | 1 (2.1) |
| Duration of treatment (mo) | 12.1 |
| Moxifloxacin | |
| No. of patients — % | 34 (72.3) |
| Duration of treatment (mo) — median (interquartile range) | 21.2 (8.8–27.9) |
| Other second-line oral agents | |
| Cycloserine | |
| No. of patients — % | 47 (100) |
| Duration of treatment (mo) — median (interquartile range) | 24.7 (12.7–28.1) |
| Ethionamide | |
| No. of patients — % | 31 (66.0) |
| Duration of treatment (mo) — median (interquartile range) | 24.0 (10.7–27.9) |
| PAS | |
| No. of patients — % | 45 (95.7) |
| Duration of treatment (mo) — median (interquartile range) | 24.9 (12.7–28.3) |
| Other agents | |
| Amoxicillin–clavulanate | |
| No. of patients — % | 47 (100) |
| Duration of treatment (mo) — median (interquartile range) | 24.0 (11.7–28.1) |
| Clarithromycin | |
| No. of patients — % | 21 (44.7) |
| Duration of treatment (mo) — median (interquartile range) | 14.5 (11.6–18.9) |
| Clofazimine | |
| No. of patients — % | 46 (97.9) |
| Duration of treatment (mo) — median (interquartile range) | 24.1 (12.5–27.9) |
| Rifabutin | |
| No. of patients — % | 8 (17.0) |
| Duration of treatment (mo) — median (interquartile range) | 12.8 (8.5–14.7) |
*
One patient died less than 1 month after starting treatment, before regimen data were recorded. Plus–minus values are means ±SD. DST denotes drug-susceptibility test, and XDR extensively drug-resistant tuberculosis.
†
Resistance to the following 12 drugs or drug classes was tested: capreomycin, cycloserine, ethambutol, ethionamide, isoniazid, kanamycin or amikacin, PAS, pyrazinamide, rifampicin, streptomycin, first-generation fluoroquinolones (ciprofloxacin, ofloxacin), and later-generation fluoroquinolones (gatifloxacin, levofloxacin, moxifloxacin).