Evidence map›Paper›PMID 32829049›Full record

ArticleInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases2020

Initial resistance to companion drugs should not be considered an exclusion criterion for the shorter multidrug-resistant tuberculosis treatment regimen.

Pauline Lempens, Tom Decroo, Kya J M Aung, Mohammad A Hossain, Leen Rigouts, Conor J Meehan, Armand Van Deun, Bouke C de Jong

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
0.3field-weighted citation impact, top 28% of its field
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

8 citing papers in PubMed, 15 citations in OpenAlex.

  1. Review
  2. Review
  3. BorderlineMicrobial genomics · 2023
    Article
  4. Drug resistance prediction forMicrobial genomics · 2023
    Article
  5. Review
  6. Review
  7. Article
  8. Article
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

8 authors at 3 institutions in 2 countries.

Pauline LempensUnit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium. Electronic address: plempens@itg.be.
Tom DecrooUnit of HIV/AIDS and Infectious Diseases, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Kya J M AungDamien Foundation, Dhaka, Bangladesh.
Mohammad A HossainDamien Foundation, Dhaka, Bangladesh.
Leen RigoutsUnit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium.
Conor J MeehanUnit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Armand Van DeunIndependent Consultant, Leuven, Belgium.
Bouke C de JongUnit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Instituut voor Tropische Geneeskunde · BEDamien Foundation · BDUniversity of Antwerp · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesWe investigated whether companion drug resistance was associated with adverse outcomes of the shorter multidrug-resistant tuberculosis (MDR-TB) treatment regimen in Bangladesh after adjustment for fluoroquinolone resistance.

methodsMDR-TB/rifampicin-resistant tuberculosis patients registered for treatment with a standardized gatifloxacin-based shorter MDR-TB treatment regimen were selected for the study. Drug resistance was determined by the proportion method, gatifloxacin and isoniazid minimum inhibitory concentration testing for selected isolates, and whole-genome sequencing.

resultsLow-level fluoroquinolone resistance and high-level fluoroquinolone resistance were the most important predictors of adverse outcomes, with pyrazinamide resistance having a significant yet lower impact. In patients with fluoroquinolone-/second-line-injectable-susceptible tuberculosis, non-eligibility for the shorter MDR-TB treatment regimen (initial resistance to pyrazinamide, ethionamide, or ethambutol) was not associated with adverse outcome (adjusted odds ratio 1.01; 95% confidence interval 0.4-2.8). Kanamycin resistance was uncommon (1.3%). Increasing levels of resistance to isoniazid predicted treatment failure, also in a subgroup of patients with high-level fluoroquinolone-resistant tuberculosis.

conclusionsOur results suggest that resistance to companion drugs in the shorter MDR-TB treatment regimen, except kanamycin resistance, is of no clinical importance as long as fluoroquinolone susceptibility is preserved. Hence, contrary to current WHO guidelines, exclusions to the standard regimen are justified only in the case of fluoroquinolone resistance. and possibly kanamycin resistance.

Indexed as

AdolescentAdultAgedAntitubercular AgentsBangladeshChildChild, PreschoolClinical ProtocolsEthambutolFemaleFluoroquinolonesHumansIsoniazidMaleMicrobial Sensitivity TestsMiddle AgedAntitubercular AgentsEthambutolFluoroquinolonesIsoniazidPyrazinamideRifampinAntimicrobial resistanceFluoroquinolonesHigh-dose isoniazidMultidrug-resistant tuberculosisShorter treatment regimenWhole-genome sequencing

Identifiers

PMID32829049
PMCPMC7670168
OpenAlexW3052006845

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.