Evidence map›Paper›PMID 38525535›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2024

Treatment of Multidrug-resistant or Rifampicin-resistant Tuberculosis With an All-oral 9-month Regimen Containing Linezolid or Ethionamide in South Africa: A Retrospective Cohort Study.

Hannah Morgan, Norbert Ndjeka, Tasnim Hasan, Medea Gegia, Fuad Mirzayev, Linh N Nguyen, Samuel Schumacher, Timothy E Schlub, Kogieleum Naidoo, Greg J Fox

Open access · hybridAbstract 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, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
4.3field-weighted citation impact, top 5% 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

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Review
  5. Observational
  6. Article
  7. Treatment Outcomes With an Oral Short Course Regimen for Rifampicin-resistant Tuberculosis in a High HIV Prevalence, Programmatic Setting in South Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025
    Article
  8. Article
  9. Article
  10. 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

10 authors at 4 institutions in 3 countries.

Hannah MorganFaculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.ORCID 0009-0000-3827-9340
Norbert NdjekaNational Department of Health, Tuberculosis Control and Management Cluster, Pretoria, South Africa.
Tasnim HasanFaculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Medea GegiaGlobal Tuberculosis Program, World Health Organisation, Geneva, Switzerland.
Fuad MirzayevGlobal Tuberculosis Program, World Health Organisation, Geneva, Switzerland.
Linh N NguyenGlobal Tuberculosis Program, World Health Organisation, Geneva, Switzerland.
Samuel SchumacherGlobal Tuberculosis Program, World Health Organisation, Geneva, Switzerland.
Timothy E SchlubFaculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Kogieleum NaidooNelson R Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa.
Greg J FoxFaculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
The University of Sydney · AUWorld Health Organization · CHDepartment of Health · ZAUniversity of KwaZulu-Natal · ZA

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundIn 2019, the South African tuberculosis program replaced ethionamide with linezolid as part of an all-oral 9-month regimen. We evaluated treatment outcomes for patients assigned to regimens including linezolid in 2019 and ethionamide in 2017.

methodsThis retrospective cohort study included patients treated for multidrug-resistant/rifampicin-resistant tuberculosis throughout South Africa between 1 January and 31 December 2017 and 1 January to 31 December 2019. The cohort treated with a 9-month regimen containing ethionamide for four months, was compared with a cohort treated with a 9-month regimen containing linezolid for 2 months. The regimens were otherwise identical. Inverse probability weighting of propensity scores was used to adjust for potential confounding. A log-binomial regression model was used to estimate adjusted relative risk (aRR) comparing 24-month outcomes between cohorts including treatment success, death, loss to follow up, and treatment failure. Adverse event data were available for the linezolid cohort.

findingsIn total, 817 patients were included in the cohort receiving ethionamide and 4244 in the cohort receiving linezolid. No evidence for a difference was observed between linezolid and ethionamide regimens for treatment success (aRR = 0.96, 95% confidence interval [CI] .91-1.01), death (aRR = 1.01, 95% CI .87-1.17) or treatment failure (aRR = 0.87, 95% CI .44-1.75). Loss to follow-up was more common in the linezolid group, although estimates were imprecise (aRR = 1.22, 95% CI .99-1.50).

conclusionsNo significant differences in treatment success and survival were observed with substitution of linezolid for ethionamide as a part of an all-oral 9-month regimen. Linezolid is an acceptable alternative to ethionamide in this shorter regimen for treatment of multidrug-resistant/rifampicin-resistant tuberculosis.

Indexed as

Antitubercular AgentsEthionamideLinezolidRifampinTuberculosis, Multidrug-ResistantAdministration, OralAdultFemaleHumansMaleMiddle AgedMycobacterium tuberculosisRetrospective StudiesSouth AfricaTreatment OutcomeYoung AdultAntitubercular AgentsEthionamideLinezolidRifampinall-oral 9-month regimenethionamidelinezolidmultidrug- resistant tuberculosis

Identifiers

PMID38525535
PMCPMC11175697
OpenAlexW4393150435

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.