Kuaban C, Noeske J, Rieder H L, Aït-Khaled N, Abena Foe J L, Trébucq A
Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon; Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon.
Independent consultant, Yaoundé, Cameroon.
Int J Tuberc Lung Dis. 2015 May;19(5):517-24. doi: 10.5588/ijtld.14.0535.
Two specialised multidrug-resistant tuberculosis (MDR-TB) treatment units in Cameroon.
To assess outcome and adverse drug events with a standardised 12-month regimen for MDR-TB among second-line drug naïve patients.
Prospective observational study of MDR-TB patients treated with a standardised 12-month regimen including gatifloxacin, clofazimine, prothionamide, ethambutol and pyrazinamide throughout, supplemented by kanamycin and isoniazid during an intensive phase of a minimum of 4 months. Progress was monitored monthly until treatment completion and twice over one year after treatment cessation.
Eighty-seven potentially eligible patients were lost and never treated due to delayed availability of test results. Among the 150/236 eligible and treated patients, 134 (89%) successfully completed treatment, 10 died, 5 were lost, 1 failed and none relapsed. The patients' mean age was 33.7 years (range 17-68), 73 (49%) were females, 120 (80%) had failed on previous treatment, 30 (20%) were human immunodeficiency virus seropositive, 62 (43%) had a body mass index <18.5 kg/m(2) and 41 (27%) had radiographic involvement of five or six of the six lung zones. The most important adverse drug event was hearing impairment, which occurred in 46 of 106 (43%) patients.
These results add further evidence for the usefulness of shorter, standardised regimens among patients without second-line drug resistance.
喀麦隆的两个专门的耐多药结核病（MDR-TB）治疗单位。
评估二线药物初治患者采用标准化12个月疗程治疗耐多药结核病的疗效和药物不良事件。
对耐多药结核病患者进行前瞻性观察研究，采用标准化12个月疗程，全程使用加替沙星、氯法齐明、丙硫异烟胺、乙胺丁醇和吡嗪酰胺，强化期至少4个月期间补充卡那霉素和异烟肼。每月监测病情进展直至治疗结束，并在停药后一年进行两次随访。
87例可能符合条件的患者因检测结果延迟获得而未接受治疗。在150/236例符合条件并接受治疗的患者中，134例（89%）成功完成治疗，10例死亡，5例失访，1例治疗失败，无复发。患者的平均年龄为33.7岁（范围17 - 68岁），73例（49%）为女性，120例（80%）既往治疗失败，30例（20%）人类免疫缺陷病毒血清学阳性，62例（43%）体重指数<18.5 kg/m²，41例（27%）六个肺区中有五个或六个肺区有影像学病变。最重要的药物不良事件是听力损害，106例患者中有46例（43%）发生。
这些结果进一步证明了在无二线药物耐药的患者中采用较短标准化疗程的有效性。
