Real-world management and outcomes of U.S. patients treated with BpaL for rifampin-resistant tuberculosis CIDJournal UF EmoryMedicine UCSF TB tuberculosis disease health healthcare
By Dr. Chinta SidharthanJun 1 2023Reviewed by Danielle Ellis, B.Sc. In a recent study published in the journal Clinical Infectious Diseases, researchers reported on the treatment of rifampin-resistant tuberculosis in the United States using the Food and Drug Administration approved bedaquiline, pretomanid, and linezolid therapy.
Furthermore, apart from the long treatment regimen, high pill burden, the toxicity of some of the drugs, prolonged respiratory isolation, and complex protocols for monitoring, rifampin-resistant tuberculosis has severe economic and psychosocial impacts on the lives of the patients and their loved ones.
While the existing protocols and guidelines for monitoring and treating patients with drug-resistant tuberculosis were followed, the management protocol was not standardized. Pre-treatment testing included physical examinations, various laboratory tests, visual acuity tests, and blood biochemistry, including metabolic, liver, and thyroid panels.
Results The results indicated that treatment with BPaL was successful for rifampin-resistant tuberculosis, with the treatment duration being less than half of those required by previous treatments for drug-resistant tuberculosis. Furthermore, the personalized dosing of linezolid implemented through therapeutic drug monitoring ensured the completion of the treatment regimen with minimum adverse reactions.
Linezolid inhibits tuberculosis growth by targeting the bacterial mitochondria and can have similar effects on human mitochondria, leading to myelosuppression in the bone marrow by inhibiting adenosine triphosphate synthesis in the bone marrow precursor cells.
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