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含贝达喹啉方案治疗青少年耐利福平结核病的24周中期结果:中国的一项回顾性队列研究

Twenty-four-week interim outcomes of bedaquiline-containing regimens in treatment of adolescents with rifampicin-resistant tuberculosis: A retrospective cohort study in China.

作者信息

Wu Hao-Yu, Tian Yao, Wang Xiao-Dan, Sun Ji-Si, Fan Li-Chao, Chen Mo-Xin, Li Ran, Chen Yu

机构信息

Department of Tuberculosis, Shenyang Tenth People's Hospital (Shenyang Chest Hospital), Shenyang, China.

Department of Tuberculosis, Changchun Infectious Disease Hospital, Changchun, China.

出版信息

J Paediatr Child Health. 2022 Jan;58(1):116-121. doi: 10.1111/jpc.15672. Epub 2021 Jul 29.

DOI:10.1111/jpc.15672
PMID:34323328
Abstract

AIM

To evaluate the 24-week interim outcomes of bedaquiline-containing regimens in the treatment of adolescents with rifampicin-resistant tuberculosis (RR-TB) in China.

METHODS

Adolescents with RR-TB from two hospitals were included in this retrospective study. All patients received the longer regimen containing bedaquiline. Sputum culture, chest computed tomography, blood tests and electrocardiography were performed regularly, and the outcomes after 24 weeks of treatment were reported.

RESULTS

Four male and six female adolescents aged 11 to 17 years old were included. Among them, four (40.0%), four (40.0%) and two (20.0%) were confirmed to have RR-TB, multidrug-resistant TB and extensively drug-resistant TB, respectively. The most common companion drugs included linezolid (100.0%), cycloserine (90.0%), pyrazinamide (80.0%), moxifloxacin (50.0%) and levofloxacin (40.0%). Culture conversion rates of 80.0%, 100.0% and 100.0% were observed at weeks 2, 4 and 24, respectively. The mean maximum drug concentration of bedaquiline at weeks 2, 12 and 24 was 3.29 ± 0.66, 1.78 ± 0.81 and 1.93 ± 0.74 μg/mL, respectively. Six adverse events including leukopenia (50.0%), Fridericia-corrected QT (QTcF) interval prolongation (16.7%), anaemia (16.7%) and peripheral neuropathy (16.7%) were observed in five (50.0%) patients. No patient discontinued bedaquiline owing to QTcF interval prolongation. Meanwhile, no deaths, reversions or serious adverse events were reported during 24 weeks of treatment.

CONCLUSION

A longer regimen containing bedaquiline was effective and well tolerated in Chinese adolescents with RR-TB. The combination of bedaquiline and linezolid may be a favourable choice for this population.

摘要

目的

评估含贝达喹啉方案治疗中国耐利福平结核病(RR-TB)青少年患者24周的中期疗效。

方法

本回顾性研究纳入了两家医院的RR-TB青少年患者。所有患者均接受含贝达喹啉的长疗程方案治疗。定期进行痰培养、胸部计算机断层扫描、血液检查和心电图检查,并报告治疗24周后的疗效。

结果

共纳入4名男性和6名女性青少年,年龄在11至17岁之间。其中,确诊为RR-TB、耐多药结核病和广泛耐药结核病的患者分别有4例(40.0%)、4例(40.0%)和2例(20.0%)。最常用的联合用药包括利奈唑胺(100.0%)、环丝氨酸(90.0%)、吡嗪酰胺(80.0%)、莫西沙星(50.0%)和左氧氟沙星(40.0%)。在第2、4和24周时,痰菌转阴率分别为80.0%、100.0%和100.0%。贝达喹啉在第2、12和24周时的平均最大血药浓度分别为

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