Doctoral Program of Pharmacy, Faculty of Pharmacy, Airlangga University; Study Program of Pharmacy, Faculty of Medicine, Hang Tuah University, Surabaya, Indonesia.
Doctoral Program of Pharmacy, Faculty of Pharmacy, Airlangga University, Surabaya, Indonesia.
Int J Mycobacteriol. 2023 Jan-Mar;12(1):1-9. doi: 10.4103/ijmy.ijmy_217_22.
Drug-resistant tuberculosis (DR-TB) is a public health concern that is difficult to treat, requiring long and complex treatment with highly effective drugs. Bedaquiline and/or delamanid have already shown promising outcomes in patients with DR-TB, increasing the rate of culture conversion and lowering TB-related mortality.
We comprehensively searched and evaluated the effectiveness of individual regimens containing bedaquiline and delamanid on culture conversion and treatment success. We assessed for quality either observational or experimental studies.
We identified 14 studies that met the inclusion criteria using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart with 12 observational and 2 experimental studies. Of 1691 DR-TB patients enrolled in the included studies, 1407 of them concomitantly received regimens containing bedaquiline and delamanid. Overall multidrug resistant (MDR), preextensively drug resistant (XDR), and XDR-TB were seen in 21.4%, 44.1%, and 34.5%, respectively. Of 14 studies, 8 of them reported favorable outcomes including sputum culture conversion and cure rate at the end of treatment, meanwhile 6 studies only reported sputum culture conversion. Sputum culture conversion at the end of the 6 month was 63.6%-94.7% for observational studies, and 87.6%-95.0% for experimental studies. The favorable outcome at the end of treatment was 67.5%-91.4%. With high pre-XDR and XDR cases among DR-TB patients with limited treatment options, regimens containing bedaquiline and delamanid provide successful treatment.
In DR-TB patients receiving regimens containing bedaquiline and delamanid, favorable outcomes were high including sputum conversion and cure rate.
耐多药结核病（DR-TB）是一种难以治疗的公共卫生问题，需要使用高效药物进行长期而复杂的治疗。贝达喹啉和/或德拉马尼已在 DR-TB 患者中显示出良好的疗效，提高了培养转换率并降低了与结核病相关的死亡率。
我们全面搜索并评估了含有贝达喹啉和德拉马尼的个体方案在培养转换和治疗成功方面的效果。我们评估了观察性或实验性研究的质量。
我们使用系统评价和荟萃分析的首选报告项目流程图确定了符合纳入标准的 14 项研究，其中包括 12 项观察性研究和 2 项实验性研究。在纳入研究的 1691 例 DR-TB 患者中，有 1407 例同时接受了含有贝达喹啉和德拉马尼的方案治疗。总体上，耐多药（MDR）、广泛耐药（XDR）和 XDR-TB 分别为 21.4%、44.1%和 34.5%。在 14 项研究中，有 8 项报告了包括痰培养转换和治疗结束时的治愈率在内的良好结局，而有 6 项研究仅报告了痰培养转换。观察性研究的痰培养转换率在治疗结束时为 63.6%-94.7%，实验性研究的痰培养转换率为 87.6%-95.0%。治疗结束时的良好结局为 67.5%-91.4%。在 DR-TB 患者中，由于治疗选择有限，XDR 病例较多，含有贝达喹啉和德拉马尼的方案提供了成功的治疗。
在接受含有贝达喹啉和德拉马尼的方案治疗的 DR-TB 患者中，痰培养转换和治愈率等良好结局的比例较高。
