Bedaquiline, pretomanid and linezolid in multidrug-resistant and pre-extensively drug-resistant tuberculosis in refugees from Ukraine and Somalia in Germany
Abstract
Extract According to the World Health Organization (WHO) 2023 tuberculosis (TB) report, in the European Union region there are approximately 200 000 TB cases per year, among which 30 000 are rifampicin resistant (RR) with treatment success rates of 57% [1], indicating a considerable gap from the United Nations' goal of an 80% reduction by 2030. In 2022, the WHO guideline for the treatment of multidrug-resistant (MDR) TB recommended as new first-line regimen for MDR-TB (resistance to at least isoniazid and rifampicin [2]) bedaquiline, pretomanid, linezolid and moxifloxacin (BPaLM), and for pre-extensively drug-resistant tuberculosis (pre-XDR-TB; MDR/RR-TB and which are also resistant to any fluoroquinolone [2]) bedaquiline, pretomanid and linezolid (BPaL) [3]. Evidence supporting the use of BPaL regimen in MDR- and pre-XDR-TB stems mostly from high-incidence countries [4–7] and case series in the USA [8, 9]. Shareable abstract In this case series, the 3-drug regimen BPaL is safe and effective not only for pre-XDR-TB, but also for MDR/RR-TB. However, as failure of BPaL would leave patients with hardly any treatment options, BPaL should currently only be used in expert centres. https://bit.ly/3VJ5yCp
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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