Instituto de Tisioneumonología Prof. Dr. Raúl Vaccarezza, Universidad de Buenos Aires, Av. Vélez Sarsfield 405, C1282, Buenos Aires, Argentina.
J Antimicrob Chemother. 2012 Feb;67(2):473-7. doi: 10.1093/jac/dkr500. Epub 2011 Dec 1.
Current drug choices to treat extensively drug-resistant (XDR) tuberculosis (TB) are scarce; therefore, information on the safety, tolerability and efficacy of alternative regimens is of utmost importance. The aim of this study was to describe the management, drug adverse effects and outcome of alternative combined treatment in a series of XDR-TB patients.
A retrospective study was performed on 17 non-AIDS, pulmonary adult patients with XDR-TB admitted to a referral treatment centre for infectious diseases in Buenos Aires from 2002 through 2008. Drug susceptibility testing was performed under regular proficiency testing and confirmed at the national TB reference laboratory.
Linezolid was included in the drug regimens of all patients; moxifloxacin and/or thioridazine were included in the regimens of 14 patients. Clinically tractable drug adverse effects were observed in nine patients, the most frequent being haematological disorders and neurotoxicity. In two patients, thioridazine was discontinued. Negative culture conversion was achieved in 15 patients, 11 completed treatment meeting cure criteria, 4 are still on follow-up with good evolution, 1 defaulted treatment and 1 was lost to follow-up.
The combination of linezolid, moxifloxacin and thioridazine is recommended for compassionate use in specialized centres with expertise in the management of XDR-TB.
目前治疗广泛耐药结核病（XDR-TB）的药物选择有限；因此，有关替代方案的安全性、耐受性和疗效的信息至关重要。本研究旨在描述一系列 XDR-TB 患者中替代联合治疗的管理、药物不良反应和结果。
对 2002 年至 2008 年期间在布宜诺斯艾利斯传染病转诊治疗中心收治的 17 例非艾滋病、肺成人 XDR-TB 患者进行了回顾性研究。药敏试验在常规能力验证下进行，并在国家结核病参考实验室得到确认。
所有患者的药物方案中均包括利奈唑胺；14 例患者的方案中包括莫西沙星和/或硫利达嗪。9 例患者出现可临床处理的药物不良反应，最常见的是血液系统疾病和神经毒性。有 2 例患者停用了硫利达嗪。15 例患者的培养转为阴性，11 例符合治愈标准完成治疗，4 例仍在随访中，病情良好，1 例患者失访，1 例患者治疗中断。
利奈唑胺、莫西沙星和硫利达嗪的联合用药推荐在具有 XDR-TB 管理专业知识的专门中心进行同情使用。
