Observational studyClinical infectious diseases : an official publication of the Infectious Diseases Society of America2016
Multidrug-Resistant Tuberculosis Treatment Outcomes in Relation to Treatment and Initial Versus Acquired Second-Line Drug Resistance.
Observational study in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 8 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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
61 citing papers in PubMed, 8 syntheses or guidelines pooled it, 101 citations in OpenAlex.
- Diabetes mellitus affects the treatment outcomes of drug-resistant tuberculosis: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- Aminoglycosides and Capreomycin in the Treatment of Multidrug-resistant Tuberculosis: Individual Patient Data Meta-analysis of 12 030 Patients From 25 Countries, 2009-2016.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Pooled it
- Drug-associated adverse events in the treatment of multidrug-resistant tuberculosis: an individual patient data meta-analysis.The Lancet. Respiratory medicine · 2020Pooled it
- Treatment of Drug-Resistant Tuberculosis. An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline.American journal of respiratory and critical care medicine · 2019Guideline
- Factors predictive of the success of tuberculosis treatment: A systematic review with meta-analysis.PloS one · 2019Pooled it
- Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis.Lancet (London, England) · 2018Pooled it
- Linezolid pharmacokinetics in MDR-TB: a systematic review, meta-analysis and Monte Carlo simulation.The Journal of antimicrobial chemotherapy · 2018Pooled it
- Comorbidities and treatment outcomes in multidrug resistant tuberculosis: a systematic review and meta-analysis.Scientific reports · 2018Pooled it
- Individualized Therapy Guided by Drug Susceptibility Testing for Multidrug-Resistant Tuberculosis.Open forum infectious diseases · 2026Article
- Evolution and rise of antimicrobial resistance in key public health bacteria within and across the One Health sectors.Future microbiology · 2026Review
- Success rates of DR-TB patients and associated factors in Tanzania: a six-year cohort study.BMC infectious diseases · 2026Article
- Community engagement strategies for antimicrobial resistance control and interventions.BMJ public health · 2026Review
- High-dose amikacin in the first week of all-oral rifampicin-resistant TB treatment is safe: a single-arm trial.IJTLD open · 2025Article
- Treatment Outcomes for Drug-Resistant Tuberculosis Patients on Bedaquiline-Based Regimens in a Mostly Rural South Africa.Infection and drug resistance · 2025Article
- Article
- Therapeutic Potential of Resveratrol and Lignans in the Management of Tuberculosis.Cell biochemistry and biophysics · 2024Review
- Article
- Detection of a historic reservoir of bedaquiline/clofazimine resistance-associated variants in Mycobacterium tuberculosis.Genome medicine · 2024Article
- At Long Last: Short, All-Oral Regimens for Multidrug-Resistant Tuberculosis in the United States.Open forum infectious diseases · 2023Review
- Molecular characterisation of second-line drug resistance among drug resistant tuberculosis patients tested in Uganda: a two and a half-year's review.BMC infectious diseases · 2022Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
77 authors at 15 institutions in 10 countries.
Funding
Abstract
backgroundResistance to second-line drugs develops during treatment of multidrug-resistant (MDR) tuberculosis, but the impact on treatment outcome has not been determined.
methodsPatients with MDR tuberculosis starting second-line drug treatment were enrolled in a prospective cohort study. Sputum cultures were analyzed at a central reference laboratory. We compared subjects with successful and poor treatment outcomes in terms of (1) initial and acquired resistance to fluoroquinolones and second-line injectable drugs (SLIs) and (2) treatment regimens.
resultsOf 1244 patients with MDR tuberculosis, 973 (78.2%) had known outcomes and 232 (18.6%) were lost to follow-up. Among those with known outcomes, treatment succeeded in 85.8% with plain MDR tuberculosis, 69.7% with initial resistance to either a fluoroquinolone or an SLI, 37.5% with acquired resistance to a fluoroquinolone or SLI, 29.3% with initial and 13.0% with acquired extensively drug-resistant tuberculosis (P < .001 for trend). In contrast, among those with known outcomes, treatment success increased stepwise from 41.6% to 92.3% as the number of drugs proven effective increased from ≤1 to ≥5 (P < .001 for trend), while acquired drug resistance decreased from 12% to 16% range, depending on the drug, down to 0%-2% (P < .001 for trend). In multivariable analysis, the adjusted odds of treatment success decreased 0.62-fold (95% confidence interval, .56-.69) for each increment in drug resistance and increased 2.1-fold (1.40-3.18) for each additional effective drug, controlling for differences between programs and patients. Specific treatment, patient, and program variables were also associated with treatment outcome.
conclusionsIncreasing drug resistance was associated in a logical stepwise manner with poor treatment outcomes. Acquired resistance was worse than initial resistance to the same drugs. Increasing numbers of effective drugs, specific drugs, and specific program characteristics were associated with better outcomes and less acquired resistance.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.