Evidence map›Paper›PMID 30165431›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019

Improved Treatment Outcomes With Bedaquiline When Substituted for Second-line Injectable Agents in Multidrug-resistant Tuberculosis: A Retrospective Cohort Study.

Ying Zhao, Tamaryn Fox, Kathryn Manning, Annemie Stewart, Nicki Tiffin, Ntokozo Khomo, Joshua Leslie, Andrew Boulle, Vanessa Mudaly, Yulene Kock and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Bedaquiline-containing regimens and multidrug-resistant tuberculosis: a systematic review and meta-analysis.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2022
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  12. Newer research transforming 24-month treatment of MDR/XDR-TB TO 6 months.Lung India : official organ of Indian Chest Society · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ying ZhaoDepartment of Medicine, University of Cape Town, Cape Town, South Africa.
Tamaryn FoxDepartment of Medicine, University of Cape Town, Cape Town, South Africa.
Kathryn ManningDepartment of Medicine, University of Cape Town, Cape Town, South Africa.
Annemie StewartClinical Research Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Nicki TiffinProvincial Health Data Centre, Western Cape Department of Health and Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Ntokozo KhomoDepartment of Medicine, University of Cape Town, Cape Town, South Africa.
Joshua LeslieDepartment of Medicine, University of Cape Town, Cape Town, South Africa.
Andrew BoulleProvincial Health Data Centre, Western Cape Department of Health and Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Vanessa MudalyDepartment of Health, Provincial Government of the Western Cape, Cape Town, South Africa.
Yulene KockDepartment of Health, Provincial Government of the Western Cape, Cape Town, South Africa.
Graeme MeintjesDepartment of Medicine, University of Cape Town, Cape Town, South Africa.
Sean WassermanDepartment of Medicine, University of Cape Town, Cape Town, South Africa.

Funding

Wellcome Trust 098316Wellcome Trust 203135/Z/16/Z
6 · The paper itself

Abstract

backgroundBedaquiline is used as a substitute for second-line injectable (SLI) intolerance in the treatment of multidrug-resistant (MDR) tuberculosis, but the efficacy and safety of this strategy is unknown.

methodsIn this retrospective cohort study adults receiving bedaquiline substitution for MDR tuberculosis therapy, plus a matched control group who did not receive bedaquiline, were identified from the electronic tuberculosis register in the Western Cape Province, South Africa. The primary outcome measure was the proportion of patients with death, loss to follow-up, or failure to achieve sustained culture conversion at 12 months of treatment.

resultsData from 162 patients who received bedaquiline substitution and 168 controls were analyzed; 70.6% were infected with human immunodeficiency virus. Unfavorable outcomes occurred in 35 of 146 (23.9%) patients in the bedaquiline group versus 51 of 141 (36.2%) in the control group (relative risk, 0.66; 95% confidence interval, .46 -.95). The number of patients with culture reversion was lower in those receiving bedaquiline (1 patient; 0.8%) than in controls (12 patients; 10.3%; P = .001). Delayed initiation of bedaquiline was independently associated with failure to achieve sustained culture conversion (adjusted odds ratio for every 30-day delay, 1.5; 95% confidence interval, 1.1-1.9). Mortality rates were similar at 12 months (11 deaths in each group; P = .97).

conclusionsSubstituting bedaquiline for SLIs in MDR tuberculosis treatment resulted in improved outcomes at 12 months compared with patients who continued taking SLIs, supporting the use of bedaquiline for MDR tuberculosis treatment in programmatic settings.

Indexed as

AdultAntitubercular AgentsCoinfectionDiarylquinolinesDrug Resistance, Multiple, BacterialEthambutolEthionamideFemaleHIVHIV InfectionsHumansIsoniazidIsoxazolesLevofloxacinMaleMycobacterium tuberculosisAntitubercular AgentsbedaquilineDiarylquinolinesEthambutolEthionamideIsoniazidIsoxazolesLevofloxacinOxazolidinonesPyrazinamideterizidonebedaquilinedrug-resistant tuberculosisHIV-associated tuberculosis

Identifiers

PMID30165431
PMCPMC6481989

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

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.