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<identifier identifierType='DOI'>10.1164/rccm.201710-2141OC</identifier>
<creators>
<creator>
<creatorName>Gunther, G.</creatorName>
<affiliation>University of Namibia, School of Medicine, Windhoek, Namibia</affiliation>
</creator>
<creator>
<creatorName>Alexandru, S.</creatorName>
<affiliation>IMSP Institutul de Ftiziopneumologie „Chiril Draganiuc“, Moldova, Republica</affiliation>
</creator>
<creator>
<creatorName>Barbuţă, R.</creatorName>
<affiliation>Spitalul Clinic Municipal, Bălţi, Moldova, Republica</affiliation>
</creator>
<creator>
<creatorName>Ciobanu, A.G.</creatorName>
<affiliation>IMSP Institutul de Ftiziopneumologie „Chiril Draganiuc“, Moldova, Republica</affiliation>
</creator>
<creator>
<creatorName>Crudu, V.N.</creatorName>
<affiliation>IMSP Institutul de Ftiziopneumologie „Chiril Draganiuc“, Moldova, Republica</affiliation>
</creator>
</creators>
<titles>
<title xml:lang='en'>Clinical management of multidrug-resistant tuberculosis in 16 european countries</title>
</titles>
<publisher>Instrumentul Bibliometric National</publisher>
<publicationYear>2018</publicationYear>
<relatedIdentifier relatedIdentifierType='ISSN' relationType='IsPartOf'>1073-449X</relatedIdentifier>
<subjects>
<subject>Extensively drug-resistant TB</subject>
<subject>management</subject>
<subject>MDR-TB</subject>
<subject>Outcome definitions</subject>
<subject>TBNET</subject>
</subjects>
<dates>
<date dateType='Issued'>2018-08-01</date>
</dates>
<resourceType resourceTypeGeneral='Text'>Journal article</resourceType>
<descriptions>
<description xml:lang='en' descriptionType='Abstract'><p>Rationale: Multidrug-resistant tuberculosis (MDR-TB) is a major burden to public health in Europe. Reported treatment success rates are around 50% or less, and cure rates are even lower. Objectives: To document the management and treatment outcome in patients with MDR-TB in Europe. Methods: We performed a prospective cohort study, analyzing management and treatment outcomes stratified by incidence of patients with MDR-TB in Europe. Treatment outcomes were compared by World Health Organization and alternative simplified definitions by the Tuberculosis Network European Trialsgroup (TBNET). Measurements and Main Results: A total of 380 patients with MDR-TB were recruited and followed up between 2010 and 2014 in 16 European countries. Patients in high-incidence countries compared with low-incidence countries were treated more frequently with standardized regimen (83.2% vs. 9.9%), had delayed treatment initiation (median, 111 vs. 28 d), developed more additional drug resistance (23% vs. 5.8%), and had increased mortality (9.4% vs. 1.9%). Only 20.1% of patients using pyrazinamide had proven susceptibility to the drug. Applying World Health Organization outcome definitions, frequency of cure (38.7% vs. 9.7%) was higher in high-incidence countries. Simplified outcome definitions that include 1 year of follow-up after the end of treatment showed similar frequency of relapse-free cure in low- (58.3%), intermediate- (55.8%), and high-incidence (57.1%) countries, but highest frequency of failure in high-incidence countries (24.1% vs. 14.6%). Conclusions: Conventional standard MDR-TB treatment regimens resulted in a higher frequency of failure compared with individualized treatments. Overall, cure from MDR-TB is substantially more frequent than previously anticipated, and poorly reflected by World Health Organization outcome definitions.</p></description>
</descriptions>
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<format>uri</format>
</formats>
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