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Volume 23, Number 10—October 2017

Dispatch

Bedaquiline and Delamanid Combination Treatment of 5 Patients with Pulmonary Extensively Drug-Resistant Tuberculosis

Andrey Maryandyshev1, Emanuele Pontali1, Simon Tiberi1, Onno Akkerman1, Shashank Ganatra1, Tsetan Dorji Sadutshang1, Jan-Willem Alffenaar1, Rohit Amale, Jai Mullerpattan, Sonam Topgyal, Zarir Farokh Udwadia, Rosella Centis1, Lia D’Ambrosio1, Giovanni Sotgiu1, and Giovanni Battista MiglioriComments to Author 
Author affiliations: Northern State Medical University, Arkhangelsk, Russia (A. Maryandyshev); Galliera Hospital, Genoa, Italy (E. Pontali); Royal London Hospital of Barts Health National Health Service Trust, London, UK (S. Tiberi); Queen Mary University of London, London (S. Tiberi); University of Groningen, Haren, the Netherlands (O. Akkerman, J.-W. Alffenaar); P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, India (S. Ganatra, R. Amale, J. Mullerpattan, Z.F. Udwadia); Delek Hospital, Dharamshala, India (T.D. Sadutshang, S. Topgyal); Maugeri Care and Research Institute, Tradate, Italy (R. Centis, L. D’Ambrosio, G.B. Migliori); Public Health Consulting Group, Lugano, Switzerland (L. D’Ambrosio); University of Sassari, Sassari, Italy (G. Sotgiu)

Main Article

Table 1

Demographics and clinical history of patients with pulmonary extensively drug-resistant TB treated with bedaquiline and delamanid*

Pt no. Country of birth/illness Age, y/
sex Risk factor No. treatments >30 d, case category Weeks ss+ and c+ before Bdq + Dlm treatment Weight at baseline (last recorded), kg MDR TB treatment duration, mo Length of hospital stay, d Previous TB drug regimen Drug resistance before Bdq + Dlm (at end of study)
1 India/India 20/F None 1, failure 200 34 (40) 50 NA Cm, Mfx, Eto, PAS, Cfz, Lzd, Cs, Rfb, Bdq S, H, R, E, Z, Fq, PAS, Km, Rfb (Lzd, Eto)
2 UK/the Netherlands 31/F Recreational drug user 8, failure 4 54 (68) 21 567 H, R, Z, E, Amk, Cm, Cfz, Pto, PAS, Cs, Mpm, Amx/Clv, Clr S, H, R, E, Z, Fq, Eto, Amk, Lzd
3 Russia/ Russia 43/M Recreational drug user 1, failure 62 54 (76) 36 887 Cm, Z, Mfx, Trd, Pto, PAS H, R, E, Fq, Km
4 Azerbaijan/Russia 17/F None 1, failure 20 53 (51) 16 256 Z, Cm, Lfx, Pto, Cs, PAS H, R, E, Z, Km, Amk, Cm, Fq
5 Tibet/India 39/F None 2, relapse 52 65 (60) 18 1,140 H, R, Z, E, Hd H, Mfx, Km, PAS, Lzd, Pto R, Km, Amk, Cm, Fq, Eto, PAS, Lzd, Hd H, Hd Mfx

*All patients were sputum smear and culture positive. Amk, amikacin; Amx/Clv, amoxicillin/Clavulanate; Bdq, bedaquiline; c+, culture positive; Cfz, clofazimine; Clr, clarithromycin; Cm, capreomycin; Cs, cycloserine; Dlm, delamanid; E, ethambutol; Eto, ethionamide; Fq, fluoroquinolone; H, isoniazid; Hd, high dose; Km, kanamycin; Lfx, levofloxacin; Lzd, linezolid; MDR TB, multidrug-resistant tuberculosis; Mfx, moxifloxacin; Mpm, meropenem; NA, not available; PAS, para-aminosalicylic acid; Pt, patient; Pto, prothionamide; R, rifampin; Rfb, rifabutin; S, streptomycin; ss+, sputum smear positive; TB, tuberculosis; Trd, terizidone; Z, pyrazinamide.

Main Article

1These authors contributed equally to this article.

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