High-dose gatifloxacin-based shorter treatment regimens for MDR/RR-TB.

The shorter treatment regimen (STR) for multidrug- or rifampicin-resistant tuberculosis (MDR/RR-TB) has achieved successful outcomes in many countries. However, there are few studies on high-dose gatifloxacin-based STR with adverse drug reactions (ADRs) and management. A prospective observational study was conducted with MDR/RR-TB patients who were treated with a standardized 9 or 12 - month regimen: including gatifloxacin (Gfx), clofazimine (Cfz), ethambutol (EMB), and pyrazinamide (PZA), and supplemented by amikacin (Am), isoniazid (INH), and prothionamide (Pto) during an intensive phase of 4 or 6 - month. Monitored ADRs monthly until treatment completion and then followed up every three months for one year. Among the 42 eligible patients, 35 (83.3%) completed treatment successfully, 1 (2.4%) lost to follow-up (LTFU), and 6 (14.3%) failed due to ADRs, with no death. The most important ADR was drug-induced liver damage, which occurred in 24 out of 42 (57.1%) patients and resulted in 4 (9.5%) failed treatments and 4 (9.5%) adjusted treatments. QT interval prolongation occurred in 17 out of 42 (40.5%) patients, 9 (21.4%) of them with the corrected QT interval according to Fridericia (QTcF) > 500 ms resulting in 7 (16.7%) adjusted treatments. This study confirmed the effectiveness of the high-dose gatifloxacin-based STR but severe ADRs, especially hepatotoxicity and QT interval prolongation should never be ignored. Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Citation

Qi Nie, Lixuan Tao, Yingying Li, Nanshan Chen, Hua Chen, Yong Zhou, Yanqiu Wang, Huidong Chen, Qiuping Tang, Xianguang Wang, Chaolin Huang, Chengfeng Yang. High-dose gatifloxacin-based shorter treatment regimens for MDR/RR-TB. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2022 Feb;115:142-148

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PMID: 34861398

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