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      Bedaquiline and delamanid for the treatment of multidrug-resistant tuberculosis: a multicentre cohort study in Korea.

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          Abstract

          Relatively little is known about the efficacy and safety of the programmatic use of bedaquiline and delamanid in multidrug-resistant tuberculosis (MDR-TB) treatment.This study evaluated 61 patients with MDR-TB treated with bedaquiline (n=39), delamanid (n=11) or both, either sequentially (n=10) or in coadministration (n=1), for >1 month, combined with a World Health Organization-recommended regimen.Of these, 49 (80.3%) were male and 12 (19.7%) were female. The median (interquartile range (IQR)) age was 53 (38.5-61.0) years. 42 (68.9%) patients had fluoroquinolone-resistant MDR-TB and 16 (26.2%) had extensively drug-resistant TB. The median (IQR) duration of treatment with bedaquiline and/or delamanid was 168 (166.5-196.5) days, with 33 (54.1%) receiving linezolid for a median (IQR) of 673 (171-736) days. Of the 55 patients with positive sputum cultures at the start of bedaquiline and/or delamanid treatment, 39 (70.9%) achieved sputum culture conversion within a median of 119 days. Treatment was halted in four patients (6.6%) because of prolonged Fridericia's corrected QT interval.Bedaquiline and delamanid were effective and safe for treating MDR-TB, with initial evidence of sequential administration of these two drugs as a viable treatment strategy for patients when an adequate treatment regimen cannot be constructed.

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          Author and article information

          Journal
          Eur Respir J
          The European respiratory journal
          European Respiratory Society (ERS)
          1399-3003
          0903-1936
          Mar 2018
          : 51
          : 3
          Affiliations
          [1 ] Mokpo National TB Hospital, Mokpo, Republic of Korea.
          [2 ] Dept of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.
          [3 ] Dept of Internal Medicine, Kwangju Christian Hospital, Gwangju, Republic of Korea.
          [4 ] Division of Respiratory Medicine and Allergy, Dept of Internal Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea.
          [5 ] Dept of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Republic of Korea.
          [6 ] Dept of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea yskwon@jnu.ac.kr.
          Article
          13993003.02467-2017
          10.1183/13993003.02467-2017
          29545276
          2d7fc4db-46fb-4495-8af1-8ed4c172c72e
          History

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