Outcomes of bedaquiline containing regimen in the treatment of adults with drug resistant tuberculosis in a tertiary care centre of Rajasthan

Abstract

The emergence of drug-resistant strains of Mycobacterium tuberculosis has become a significant public health problem and has led to a setback in efforts to end tuberculosis (TB) worldwide. The longer duration, heavier pill load, and higher toxicity profile of DR-TB regimens compared to those for drug-susceptible TB (DS-TB) lead to reduced adherence and worse treatment results, including mortality. This study was conducted to estimate treatment outcomes and adverse effects in patients with drug-resistant TB patients on bedaquiline-containing regimen. Patients after the pre-treatment evaluation were enrolled for bedaquiline-containing regimen. These patients were followed up for 18 months and the final outcome was assessed along with the adverse effects. It was found that 49 (84.4%) patients achieved culture conversion by three months and 54 (93.1%) achieved culture conversion by six months, 52 (83.81%) patients had favourable outcomes (cured, treatment completed) and 10 patients had unfavourable outcomes (died, lost to follow-up, failed). Coupled with gradually increasing trends of success rates from 2012, lesser failure rates and lesser concerns regarding grave adverse effects are a silver lining along the cloud of increasing burden and widening resistance patterns. More funding has to be directed towards ensuring adherence and finding high-risk individuals in order to expedite the achievement of sustainable development (SDG) goals.

Keywords

• tuberculosis
• MDR tuberculosis
• XDR-TB
• diarylquinoline