ArticlePloS one2013
Aggressive regimens for multidrug-resistant tuberculosis decrease all-cause mortality.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Predictors of mortality in patients with drug-resistant tuberculosis: A systematic review and meta-analysis.PloS one · 2021Pooled it
- Comorbidities and treatment outcomes in multidrug resistant tuberculosis: a systematic review and meta-analysis.Scientific reports · 2018Pooled it
- Survival Probability in Multidrug Resistant Pulmonary Tuberculosis Patients in a South Indian Region.Hospital pharmacy · 2024Article
- Genetic Characterization and Population Structure of Drug-ResistantAntibiotics (Basel, Switzerland) · 2024Article
- Unsuccessful treatment outcome and associated risk factors. A prospective study of DR-TB patients from a high burden country, Pakistan.PloS one · 2023Observational
- Clinical outcomes among patients with tuberculous meningitis receiving intensified treatment regimens.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2021Article
- Treatment outcomes of drug resistant tuberculosis patients with multiple poor prognostic indicators in Uganda: A countrywide 5-year retrospective study.Journal of clinical tuberculosis and other mycobacterial diseases · 2021Article
- Comparison of censoring assumptions to reduce bias in tuberculosis treatment cohort analyses.PloS one · 2020Article
- Type I interferon-driven susceptibility to Mycobacterium tuberculosis is mediated by IL-1Ra.Nature microbiology · 2019Article
- Improving outcomes for multi-drug-resistant tuberculosis in the Peruvian Amazon - a qualitative study exploring the experiences and perceptions of patients and healthcare professionals.BMC health services research · 2019Article
- Use of predicted vital status to improve survival analysis of multidrug-resistant tuberculosis cohorts.BMC medical research methodology · 2018Article
- Prevalence and risk factors of multi-drug resistant tuberculosis in Dalian, China.The Journal of international medical research · 2017Article
- Fluoroquinolone Resistance Mutation Detection Is Equivalent to Culture-Based Drug Sensitivity Testing for Predicting Multidrug-Resistant Tuberculosis Treatment Outcome: A Retrospective Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Article
- WHO Treatment Guidelines for Drug-Resistant Tuberculosis, 2016 Update: Applicability in South Korea.Tuberculosis and respiratory diseases · 2017Review
- Clinical Implications of New Drugs and Regimens for the Treatment of Drug-resistant Tuberculosis.Chonnam medical journal · 2017Review
- Risk factors for poor multidrug-resistant tuberculosis treatment outcomes in Kyiv Oblast, Ukraine.BMC infectious diseases · 2017Article
- Totality of outcomes: A different paradigm in assessing interventions for treatment of tuberculosis.Journal of clinical tuberculosis and other mycobacterial diseases · 2016Article
- Presumptive treatment of multidrug-resistant tuberculosis in household contacts.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2016Article
- Gyrase Mutations Are Associated with Variable Levels of Fluoroquinolone Resistance in Mycobacterium tuberculosis.Journal of clinical microbiology · 2016Article
- Efficacy and effect of free treatment on multidrug-resistant tuberculosis.Experimental and therapeutic medicine · 2016Article
Corrections and comments
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Authors and funding
25 authors at 8 institutions in 2 countries.
Funding
Abstract
rationaleA better understanding of the composition of optimal treatment regimens for multidrug-resistant tuberculosis (MDR-TB) is essential for expanding universal access to effective treatment and for developing new therapies for MDR-TB. Analysis of observational data may inform the definition of an optimized regimen.
objectivesThis study assessed the impact of an aggressive regimen-one containing at least five likely effective drugs, including a fluoroquinolone and injectable-on treatment outcomes in a large MDR-TB patient cohort.
methodsThis was a retrospective cohort study of patients treated in a national outpatient program in Peru between 1999 and 2002. We examined the association between receiving an aggressive regimen and the rate of death. MEASUREMENTS AND MAIN
resultsIn total, 669 patients were treated with individualized regimens for laboratory-confirmed MDR-TB. Isolates were resistant to a mean of 5.4 (SD 1.7) drugs. Cure or completion was achieved in 66.1% (442) of patients; death occurred in 20.8% (139). Patients who received an aggressive regimen were less likely to die (crude hazard ratio [HR]: 0.62; 95% CI: 0.44,0.89), compared to those who did not receive such a regimen. This association held in analyses adjusted for comorbidities and indicators of severity (adjusted HR: 0.63; 95% CI: 0.43,0.93).
conclusionsThe aggressive regimen is a robust predictor of MDR-TB treatment outcome. TB policy makers and program directors should consider this standard as they design and implement regimens for patients with drug-resistant disease. Furthermore, the aggressive regimen should be considered the standard background regimen when designing randomized trials of treatment for drug-resistant TB.
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