dc.contributor.author | Ahuja, Shama D. | |
dc.contributor.author | Ashkin, David | |
dc.contributor.author | Avendano, Monika | |
dc.contributor.author | Banerjee, Rita | |
dc.contributor.author | Bauer, Melissa | |
dc.contributor.author | Bayona, Jamie N. | |
dc.contributor.author | Becerra, Mercedes C. | |
dc.contributor.author | Benedetti, Andrea | |
dc.contributor.author | Burgos, Marcos | |
dc.contributor.author | Centis, Rosella | |
dc.contributor.author | Chan, Eward D. | |
dc.contributor.author | Chiang, Chen-Yuan | |
dc.contributor.author | Cox, Helen | |
dc.contributor.author | D'Ambrosio, Lia | |
dc.contributor.author | DeRiemer, Kathy | |
dc.contributor.author | Dung, Nguyen Huy | |
dc.contributor.author | Enarson, Donald | |
dc.contributor.author | Falzon, Dennis | |
dc.contributor.author | Flanagan, Katherine | |
dc.contributor.author | Flood, Jennifer | |
dc.contributor.author | Garcia-Garcia, Maria L. | |
dc.contributor.author | Gandhi, Neel | |
dc.contributor.author | Granich, Reuben M. | |
dc.contributor.author | Hollm-Delgado, Maria G. | |
dc.contributor.author | Holtz, Timothy H. | |
dc.contributor.author | Iseman, Michael D. | |
dc.contributor.author | Jarlsberg, Leah G. | |
dc.contributor.author | Keshavjee, Salmaan A. | |
dc.contributor.author | Kim, Hye-Ryoun | |
dc.contributor.author | Koh, Won-Jung | |
dc.contributor.author | Lancaster, Joey | |
dc.contributor.author | Lange, Christophe | |
dc.contributor.author | de Lange, Wiel C. M. | |
dc.contributor.author | Leimane, Vaira | |
dc.contributor.author | Leung, Chi Chiu | |
dc.contributor.author | Li, Jiehui | |
dc.contributor.author | Menzies, Dick | |
dc.contributor.author | Migliori, Giovanni B. | |
dc.contributor.author | Mishustin, Sergey P. | |
dc.contributor.author | Mitnick, Carole Diane | |
dc.contributor.author | Narita, Masa | |
dc.contributor.author | O'Riordan, Philly | |
dc.contributor.author | Pai, Madhukar | |
dc.contributor.author | Palmero, Domingo | |
dc.contributor.author | Park, Seung-kyu | |
dc.contributor.author | Pasvol, Geoffrey | |
dc.contributor.author | Peña, Jose | |
dc.contributor.author | Pérez-Guzmán, Carlos | |
dc.contributor.author | Quelapio, Maria I. D. | |
dc.contributor.author | Ponce-de-Leon, Alfredo | |
dc.contributor.author | Riekstina, Vija | |
dc.contributor.author | Robert, Jerome | |
dc.contributor.author | Royce, Sarah | |
dc.contributor.author | Schaaf, H. Simon | |
dc.contributor.author | Seung, Kwonjune Justin | |
dc.contributor.author | Shah, Lena | |
dc.contributor.author | Shim, Tae Sun | |
dc.contributor.author | Shin, Sonya Sunhi | |
dc.contributor.author | Shiraishi, Yuji | |
dc.contributor.author | Sifuentes-Osornio, José | |
dc.contributor.author | Sotgiu, Giovanni | |
dc.contributor.author | Strand, Matthew J. | |
dc.contributor.author | Tabarsi, Payam | |
dc.contributor.author | Tupasi, Thelma E. | |
dc.contributor.author | van Altena, Robert | |
dc.contributor.author | Van der Walt, Martie | |
dc.contributor.author | Van der Werf, Tjip S. | |
dc.contributor.author | Vargas, Mario H. | |
dc.contributor.author | Viiklepp, Pirett | |
dc.contributor.author | Westenhouse, Janice | |
dc.contributor.author | Yew, Wing Wai | |
dc.contributor.author | Yim, Jae-Joon | |
dc.date.accessioned | 2013-04-26T18:09:57Z | |
dc.date.issued | 2012 | |
dc.identifier.citation | Ahuja, 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.issn | 1549-1277 | en_US |
dc.identifier.uri | http://nrs.harvard.edu/urn-3:HUL.InstRepos:10589800 | |
dc.description.abstract | Background: 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.iso | en_US | en_US |
dc.publisher | Public Library of Science | en_US |
dc.relation.isversionof | doi:10.1371/journal.pmed.1001300 | en_US |
dc.relation.hasversion | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3429397/pdf/ | en_US |
dash.license | LAA | |
dc.subject | Medicine | en_US |
dc.subject | Global Health | en_US |
dc.subject | Infectious Diseases | en_US |
dc.subject | Public Health | en_US |
dc.title | Multidrug Resistant Pulmonary Tuberculosis Treatment Regimens and Patient Outcomes: An Individual Patient Data Meta-analysis of 9,153 Patients | en_US |
dc.type | Journal Article | en_US |
dc.description.version | Version of Record | en_US |
dc.relation.journal | PLoS Medicine | en_US |
dash.depositing.author | Becerra, Mercedes C. | |
dc.date.available | 2013-04-26T18:09:57Z | |
dc.identifier.doi | 10.1371/journal.pmed.1001300 | * |
dash.authorsordered | false | |
dash.contributor.affiliated | Becerra, Mercedes | |
dash.contributor.affiliated | Mitnick, Carole | |
dash.contributor.affiliated | Keshavjee, Salmaan | |
dash.contributor.affiliated | Seung, Kwonjune | |
dash.contributor.affiliated | Shin, Sonya | |