P-2315. Clinical outcome of rifabutin-based treatment for pulmonary tuberculosis in solid organ transplant recipients
Abstract
Abstract Background Rifabutin (Rfb) is commonly administered instead of rifampicin for the treatment of tuberculosis (TB) in SOTR to avoid substantial drug interaction of rifampin. However, evidence of its efficacy is scarce. Methods We conducted a retrospective, case-control study at Samsung Medical Center. The SOTR group included SOTR aged ≥ 18 years who were diagnosed with culture-positive pulmonary TB and treated with anti-TB medications that included both isoniazid (INH) and Rfb for > 80% of the total treatment duration. Patients who discontinued immunosuppressants before TB diagnosis and those with rifampin-resistant TB were excluded. The SOTR group was matched with a 1:3 ratio to the non-SOTRs who were treated with rifampin-based regimens. The primary outcome was survival treatment completion without early relapse. Logistic regression with and without overlap weighting was used to evaluate outcome measures. Results A total of 40 SOTRs and 120 non-SOTRs were enrolled. There was no difference between the two groups in the presence of cavitary lesions, smear-positivity, or culture-positivity at two months. However, extrapulmonary TB and INH resistance were significantly more frequent in the SOTR group. Most SOTRs had kidney transplants, followed by liver transplants. The proportions of deceased donors and living donors were 50% each. The primary outcome was achieved in 90% vs. 96.7% in SOTRs and controls, respectively (P=0.108). However, the completion of treatment was…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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