关键词: 结核, 抗多种药物性, 抗结核药, 药物评价

Abstract:

Objective: To retrospectively analyze the efficacy of regimen containing bedaquiline in the treatment of 12 adolescent drug-resistant pulmonary tuberculosis (TB) patients. Methods: From April 2020 to January 2021, 12 adolescent patients under 18 years old with drug-resistant TB who used bedaquiline regimen in Beijing Chest Hospital were enrolled, of them, 3 with rifampicin-resistant (RR), 5 with multidrug-resistant (MDR), and 4 with pre-extensively drug-resistant (pre-XDR). TB culture conversion rate and lesions absorption after 24 weeks were analyzed to assess the treatment efficacy. The adverse effects such as changes of QTc in ECG were recorded to assess the treatment safety. Results: All the 12 cases completed the 24-week treatment and the culture achieved negative conversion. Chest CT scan showed significant effect in 8 cases and effective in 4 cases. Among 6 patients with lung cavities, cavity in the lung became smaller or the number reduced in 4 cases, and 2 showed cavity closure. Adverse effects included prolonged QT interval (n=1), peripheral neuropathy (n=3), damaged optic nerve (n=2), headache (n=1), shaking hands (n=1), tinnitus (n=1), anemia (n=2), gastrointestinal reaction (n=3), elevated transaminase (n=3), and hyperuricemia (n=2), however, all of the patients did not stop using bedaquiline. Conclusion: The negative conversion rates of culture in adolescent patients with drug-resistant TB was relatively high after receiving 24 weeks regimen containing bedaquiline, and the tolerance was relatively good.

Key words: Tuberculosis, multidrug-resistant, Antitubercular agents, Drug evaluation