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一项针对 2009 年至 2020 年广泛耐药结核病的系统评价:特别关注治疗结果。

A systematic review on extensively drug-resistant tuberculosis from 2009 to 2020: special emphases on treatment outcomes.

机构信息

Shruti Subhash Shiromwar, Research Scholar, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Pulau Pinang, Malaysia.

出版信息

Rev Esp Quimioter. 2023 Feb;36(1):30-44. doi: 10.37201/req/029.2022. Epub 2022 Dec 9.

Abstract

OBJECTIVE

Extensively drug-resistant tuberculosis (XDR-TB) has raised a great threat to human health globally, especially in developing countries. The objective of the present study is to collate and contrast the proportions of treatment outcome in the previously published XDR-TB articles.

METHODS

By considering inclusion criteria and search engines, a total of 22 articles were enrolled.

RESULTS

Our findings revealed that the overall favorable treatment outcome was 24.04%. From the cohort of enrolled studies 19.76% (397) and 43.35% (871) patients were cured and died respectively. In 90.9% of enrolled articles, the investigators performed drug-susceptibility testing at the baseline. The overall treatment outcome was improved by the use of new drugs (linezolid, bedaquiline, ciprofloxacin, clofazimine) in the treatment regimen of XDR-TB showing linezolid and bedaquiline better results i.e. 59.44 and 78.88%, respectively. Moreover, use of antiretroviral treatment in XDR-TB patients with HIV infection have not shown any significant difference in the treatment outcome.

CONCLUSIONS

XDR-TB treatment success can be achieved by implying standardized definitions, upgraded diagnostic procedures, and novel drugs.

摘要

目的

广泛耐药结核病(XDR-TB)对全球人类健康构成了巨大威胁,尤其是在发展中国家。本研究旨在整理和对比已发表的 XDR-TB 文章中治疗结果的比例。

方法

通过考虑纳入标准和搜索引擎,共纳入 22 篇文章。

结果

我们的研究结果显示,总体上有利的治疗结果为 24.04%。在纳入的研究队列中,19.76%(397 例)和 43.35%(871 例)的患者分别治愈和死亡。在 90.9%的纳入文章中,研究人员在基线时进行了药物敏感性测试。在 XDR-TB 的治疗方案中使用新药(利奈唑胺、贝达喹啉、环丙沙星、氯法齐明)可改善总体治疗结果,利奈唑胺和贝达喹啉的结果分别为 59.44%和 78.88%。此外,在 HIV 感染的 XDR-TB 患者中使用抗逆转录病毒治疗并未显示在治疗结果方面有任何显著差异。

结论

通过实施标准化定义、升级诊断程序和新型药物,可以实现 XDR-TB 的治疗成功。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70c2/9910680/95bac02bd9c0/revespquimioter-36-030-g001.jpg

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