Volume 23, Number 10—October 2017
Dispatch
Bedaquiline and Delamanid Combination Treatment of 5 Patients with Pulmonary Extensively Drug-Resistant Tuberculosis
Table 2
Summary of patients treated with bedaquiline and delamanid, including data on the anti-TB regimen administered, bacteriological conversion, treatment outcomes, and QT interval monitoring*
Pt no. | Last TB drug regimen administered | Sputum smear/culture conversion, d (treatment outcome) | Dlm/Bdq exposure, d | QT before treatment, ms | QT average, ms (±SD) | QT max, ms (wk) |
---|---|---|---|---|---|---|
1 | Cm, Mfx, Eto, Cs, PAS, Cfz, Mpm, Lfx, Amx/Clv, Lzd, Bdq, Dlm | NA/NA (failure; 4 mo after completing Bdq + Dlm treatment course, patient died because of respiratory insufficiency) | 168/168 | 410 | 426 (±17.6) | 450 (9) |
2 | Hd H, Cfz, Cs, E, Lzd, Dlm, Bdq; as of April 28, 2017, receving: Hd H, Cs, Cfz, cotrimoxazole | 60/60 (continued treatment) | 168/168 | 400 | 406 (±33.6) | 462 (24) |
3 | Cm, Mfx, Bdq, Dlm, Lzd, Imp, Amx/Clv | 435/104 (cured) | 180/180 | 340 | 363 (±25.8) | 400 (35 and 51) |
4 | Bdq, Dlm, Lzd, Cfz | 30/30 (continued treatment) | 155/155 | 394 | 462 (±39.8) | 509 (5 and 9) |
5 | Dlm, Bdq, Cfz, Trd, Mpm, Amx/Clv | 18/28 (continued treatment) | 427/427 | 449 | 504 (±6.3) | 520 (16)† |
*Amk, amikacin; Amx/Clv, amoxicillin/clavulanate; Bdq, bedaquiline; Cfz, clofazimine; Cm, capreomycin; Cs, cycloserine; Dlm, delamanid; E, ethambutol; Eto, ethionamide; H, isoniazid; Hd, high dose; Imp, imipenem; Lfx, levofloxacin; Lzd, linezolid; max, maximum; Mfx, moxifloxacin; Mpm, meropenem; NA, not achieved; PAS, para-aminosalicylic acid; Pto, prothionamide; Pt, patient; QT, measure of the time between the start of the Q wave and the end of the T wave in the heart's electrical cycle; SD, standard deviation; TB, tuberculosis; Trd, terizidone.
†At different time points, intermittent episodes of asymptomatic QTc prolongation occurred.
1These authors contributed equally to this article.