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Volume 25, Number 3—March 2019
CME ACTIVITY - Synopsis

Treatment Outcomes in Global Systematic Review and Patient Meta-Analysis of Children with Extensively Drug-Resistant Tuberculosis

Muhammad OsmanComments to Author , Elizabeth P. Harausz, Anthony J. Garcia-Prats, H. Simon Schaaf, Brittany K. Moore, Robert M. Hicks1, Jay Achar, Farhana Amanullah, Pennan Barry, Mercedes Becerra, Domnica I. Chiotan, Peter C. Drobac2, Jennifer Flood, Jennifer Furin, Medea Gegia, Petros Isaakidis, Andrei Mariandyshev, Iveta Ozere, N. Sarita Shah3, Alena Skrahina, Elena Yablokova, James A. Seddon4, Anneke C. Hesseling4, and for The Collaborative Group for Meta-Analysis of Paediatric Individual Patient Data in MDR TB
Author affiliations: Stellenbosch University, Cape Town, South Africa (M. Osman, A.J. Garcia-Prats, H.S. Schaaf, J.A. Seddon, A.C. Hesseling); State University of New York Upstate Medical University, Syracuse, New York, USA (E.P. Harausz); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (B.K. Moore); University of California, San Francisco, California, USA (R.M. Hicks); Médecins Sans Frontières, London, UK (J. Achar); Indus Hospital, Karachi, Pakistan (F. Amanullah); California Department of Public Health, Richmond, California, USA (P. Barry, J. Flood); Harvard Medical School, Boston, Massachusetts, USA (M. Becerra, P.C. Drobac, J. Furin); Romanian National TB Program, Bucharest, Romania (D.I. Chiotan); World Health Organization, Geneva, Switzerland (M. Gegia); Médecins Sans Frontières, Mumbai, India (P. Isaakidis); Northern State Medical University, Arkhangelsk, Russia (A. Mariandyshev, E. Yablokova); Riga Eastern Clinical University Hospital, Riga, Latvia (I. Ozere); Albert Einstein College of Medicine, Bronx, New York, USA (N.S. Shah); Republican Research and Practical Centre for Pulmonology and TB, Minsk, Belarus (A. Skrahina); Imperial College London, London (J.A. Seddon)

Main Article

Table 3

Demographic and clinical characteristics of 7 children with unfavorable treatment outcomes for XDR TB*

Child Year of treatment Age, y/sex† Weight, kg, at start of XDR TB treatment HIV status History of TB Previous TB outcome Disease site Chest radiograph result‡ Drugs to which isolate was resistant Drugs used at any stage during XDR TB treatment Outcome
1 2008 9/F 23 – No No PTB Normal INH, RIF, OFX, AMK, STR, EMB INH, CAP, EMB, PZA, ETH, PAS Lost to follow-up
2 2008 14/F 41 – U, DST Failure PTB Nonsevere typical TB INH, RIF, OFX, AMK, STR Not specified Lost to follow-up
3 2007 6/M 20 + No No PTB Nonsevere typical TB INH, RIF, CIP, AMK, STR, EMB AMK, EMB, PZA, ETH, CIP Died
4 2007 14/M 42 + DS TB No PTB, EPTB Severe not typical TB INH, RIF, OFX, KAN, STR, EMB, ETH, PAS CAP, MXF, LVX, ETH, CYS, PAS, AMX, CLA Died
5 2001 13/F U U DR TB Failure PTB Nonsevere typical TB INH, RIF, LVX, CIP, KAN, AMK, CAP, STR, EMB, PZA, ETH, PAS CAP, STR, LVX, CIP, ETH, CYS, PAS, AMX, CLA Died
6 2009 12/F 19.5 + Both Failure PTB Nonsevere typical TB INH, RIF, OFX, KAN CAP, MXF, EMB, PZA, ETH, CYS, PAS, AMX, CLA, CLM Failure
7 2013 13/F 34 – U No PTB U INH, RIF, MXF, OFX, KAN, AMK, CAP, STR, EMB, PZA, ETH CAP, LVX, PZA, ETH, CYS, PAS Died

*Ethionamide or prothionamide was not differentially recorded; where ethionamide is stated, it implies that 1 of the 2 dugs was used. Cycloserine or terizidone was not differentially recorded; where cycloserine is stated, it implies that 1 of the 2 drugs was used. AMK, amikacin; AMX, amoxicillin; CAP, capreomycin; CIP, ciprofloxacin; CLA, clavulanic acid; CLM, clarithromycin; CYS, cycloserine; DS, drug sensitive; DR, drug resistant; DST, drug susceptibility testing; EMB, ethambutol; EPTB, extrapulmonary tuberculosis; ETH, ethionamide; INH, isoniazid; KAN, kanamycin; LVX, levofloxacin; LZD, linezolid; MXF, moxifloxacin; OFX, ofloxacin; PAS, para-aminosalicylic acid; PTB, pulmonary tuberculosis; PZA, pyrazinamide; RIF, rifampin; STR, streptomycin; TB, tuberculosis; U, unknown; XDR TB, extensively drug-resistant tuberculosis; –, negative; +, positive.
†Age at year of diagnosis.
‡By adapted Wiseman classification.

Main Article

1Current affiliation: University of California, San Francisco, California, USA.

2Current affiliation: Oxford University, Oxford, UK.

3Current affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

4These senior authors contributed equally to this article.

Page created: February 19, 2019
Page updated: February 19, 2019
Page reviewed: February 19, 2019
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