Show simple item record

dc.contributor.authorAhuja, Shama D.
dc.contributor.authorAshkin, David
dc.contributor.authorAvendano, Monika
dc.contributor.authorBanerjee, Rita
dc.contributor.authorBauer, Melissa
dc.contributor.authorBayona, Jamie N.
dc.contributor.authorBecerra, Mercedes C.
dc.contributor.authorBenedetti, Andrea
dc.contributor.authorBurgos, Marcos
dc.contributor.authorCentis, Rosella
dc.contributor.authorChan, Eward D.
dc.contributor.authorChiang, Chen-Yuan
dc.contributor.authorCox, Helen
dc.contributor.authorD'Ambrosio, Lia
dc.contributor.authorDeRiemer, Kathy
dc.contributor.authorDung, Nguyen Huy
dc.contributor.authorEnarson, Donald
dc.contributor.authorFalzon, Dennis
dc.contributor.authorFlanagan, Katherine
dc.contributor.authorFlood, Jennifer
dc.contributor.authorGarcia-Garcia, Maria L.
dc.contributor.authorGandhi, Neel
dc.contributor.authorGranich, Reuben M.
dc.contributor.authorHollm-Delgado, Maria G.
dc.contributor.authorHoltz, Timothy H.
dc.contributor.authorIseman, Michael D.
dc.contributor.authorJarlsberg, Leah G.
dc.contributor.authorKeshavjee, Salmaan A.
dc.contributor.authorKim, Hye-Ryoun
dc.contributor.authorKoh, Won-Jung
dc.contributor.authorLancaster, Joey
dc.contributor.authorLange, Christophe
dc.contributor.authorde Lange, Wiel C. M.
dc.contributor.authorLeimane, Vaira
dc.contributor.authorLeung, Chi Chiu
dc.contributor.authorLi, Jiehui
dc.contributor.authorMenzies, Dick
dc.contributor.authorMigliori, Giovanni B.
dc.contributor.authorMishustin, Sergey P.
dc.contributor.authorMitnick, Carole Diane
dc.contributor.authorNarita, Masa
dc.contributor.authorO'Riordan, Philly
dc.contributor.authorPai, Madhukar
dc.contributor.authorPalmero, Domingo
dc.contributor.authorPark, Seung-kyu
dc.contributor.authorPasvol, Geoffrey
dc.contributor.authorPeña, Jose
dc.contributor.authorPérez-Guzmán, Carlos
dc.contributor.authorQuelapio, Maria I. D.
dc.contributor.authorPonce-de-Leon, Alfredo
dc.contributor.authorRiekstina, Vija
dc.contributor.authorRobert, Jerome
dc.contributor.authorRoyce, Sarah
dc.contributor.authorSchaaf, H. Simon
dc.contributor.authorSeung, Kwonjune Justin
dc.contributor.authorShah, Lena
dc.contributor.authorShim, Tae Sun
dc.contributor.authorShin, Sonya Sunhi
dc.contributor.authorShiraishi, Yuji
dc.contributor.authorSifuentes-Osornio, José
dc.contributor.authorSotgiu, Giovanni
dc.contributor.authorStrand, Matthew J.
dc.contributor.authorTabarsi, Payam
dc.contributor.authorTupasi, Thelma E.
dc.contributor.authorvan Altena, Robert
dc.contributor.authorVan der Walt, Martie
dc.contributor.authorVan der Werf, Tjip S.
dc.contributor.authorVargas, Mario H.
dc.contributor.authorViiklepp, Pirett
dc.contributor.authorWestenhouse, Janice
dc.contributor.authorYew, Wing Wai
dc.contributor.authorYim, Jae-Joon
dc.date.accessioned2013-04-26T18:09:57Z
dc.date.issued2012
dc.identifier.citationAhuja, Shama D., David Ashkin, Monika Avendano, Rita Banerjee, Melissa Bauer, Jamie N. Bayona, Mercedes C. Becerra, et al. 2012. Multidrug resistant pulmonary tuberculosis treatment regimens and patient outcomes: an individual patient data meta-analysis of 9,153 patients. PLoS Medicine 9(8): e1001300.en_US
dc.identifier.issn1549-1277en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:10589800
dc.description.abstractBackground: Treatment of multidrug resistant tuberculosis (MDR-TB) is lengthy, toxic, expensive, and has generally poor outcomes. We undertook an individual patient data meta-analysis to assess the impact on outcomes of the type, number, and duration of drugs used to treat MDR-TB. Methods and Findings: Three recent systematic reviews were used to identify studies reporting treatment outcomes of microbiologically confirmed MDR-TB. Study authors were contacted to solicit individual patient data including clinical characteristics, treatment given, and outcomes. Random effects multivariable logistic meta-regression was used to estimate adjusted odds of treatment success. Adequate treatment and outcome data were provided for 9,153 patients with MDR-TB from 32 observational studies. Treatment success, compared to failure/relapse, was associated with use of: later generation quinolones, (adjusted odds ratio [aOR]: 2.5 [95% CI 1.1–6.0]), ofloxacin (aOR: 2.5 [1.6–3.9]), ethionamide or prothionamide (aOR: 1.7 [1.3–2.3]), use of four or more likely effective drugs in the initial intensive phase (aOR: 2.3 [1.3–3.9]), and three or more likely effective drugs in the continuation phase (aOR: 2.7 [1.7–4.1]). Similar results were seen for the association of treatment success compared to failure/relapse or death: later generation quinolones, (aOR: 2.7 [1.7–4.3]), ofloxacin (aOR: 2.3 [1.3–3.8]), ethionamide or prothionamide (aOR: 1.7 [1.4–2.1]), use of four or more likely effective drugs in the initial intensive phase (aOR: 2.7 [1.9–3.9]), and three or more likely effective drugs in the continuation phase (aOR: 4.5 [3.4–6.0]). Conclusions: In this individual patient data meta-analysis of observational data, improved MDR-TB treatment success and survival were associated with use of certain fluoroquinolones, ethionamide, or prothionamide, and greater total number of effective drugs. However, randomized trials are urgently needed to optimize MDR-TB treatment.en_US
dc.language.isoen_USen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.isversionofdoi:10.1371/journal.pmed.1001300en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3429397/pdf/en_US
dash.licenseLAA
dc.subjectMedicineen_US
dc.subjectGlobal Healthen_US
dc.subjectInfectious Diseasesen_US
dc.subjectPublic Healthen_US
dc.titleMultidrug Resistant Pulmonary Tuberculosis Treatment Regimens and Patient Outcomes: An Individual Patient Data Meta-analysis of 9,153 Patientsen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalPLoS Medicineen_US
dash.depositing.authorBecerra, Mercedes C.
dc.date.available2013-04-26T18:09:57Z
dc.identifier.doi10.1371/journal.pmed.1001300*
dash.authorsorderedfalse
dash.contributor.affiliatedBecerra, Mercedes
dash.contributor.affiliatedMitnick, Carole
dash.contributor.affiliatedKeshavjee, Salmaan
dash.contributor.affiliatedSeung, Kwonjune
dash.contributor.affiliatedShin, Sonya


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record