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Extensively Drug-Resistant TB Tackled in Outpatients

Success rates similar to those for multidrug-resistant tuberculosis

WEDNESDAY, Aug. 6 (HealthDay News) -- Patients with extensively drug-resistant tuberculosis can be successfully treated in an outpatient setting, if they are HIV-negative, according to a report published in the Aug. 7 issue of the New England Journal of Medicine.

Carole D. Mitnick, of Harvard Medical School in Boston, and colleagues conducted a study of 810 patients in Peru who were referred for individualized outpatient therapy to treat tuberculosis. Isolates from 651 patients were tested for extensively drug-resistant tuberculosis and regimens including at least five drugs to which the isolate was not resistant were developed.

Extensively drug-resistant tuberculosis was detected in 48 of the 651 patients (7.4 percent), while the remainder had multidrug-resistant tuberculosis, the researchers report. None of the extensively drug-resistant tuberculosis patients were HIV-positive and they received daily supervised therapy. In all, 29 patients (60.4 percent) were either cured or completed treatment, versus 400 (66.3 percent) of the patients with multidrug-resistant tuberculosis, the report indicates.

"Despite the limited resources in Peru, aggressive regimens, as part of a comprehensive outpatient therapeutic approach, cured more than half of patients with extensively drug-resistant tuberculosis, who had previously been treated for tuberculosis," the authors write. "This strategy has now been integrated into the routine approach to treatment in Peru's National Tuberculosis Program."

The study received support from the Eli Lilly Foundation.

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