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0223U005824,
0122U000554
,
To improve of antimycobacterial therapy with using new modified short-term treatment regimens in patients with chemoresistant pulmonary tuberculosis
Lytvynenko Nataliia A., Доктор медичних наук
31-12-2023
State organization "National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky National academy of medical sciences of Ukraine"
Object – 965 patients with MDR TB. Aim: to determine the optimal patient triage algorithms for the selection of optimal new modified short-term regimens of antimycobacterial therapy (AMBT) in patients with drug-resistant pulmonary tuberculosis (TB), which will increase the effectiveness of treatment and save public funds. Methods: clinical, radiological, laboratory, microbiological. The direct results of modified short-term regimens (mSTR) of AMBT for patients with pulmonary drug-resistant TB, different in composition and duration, were studied. It was established that the effectiveness of treatment for 6-9 months of mSTR of different composition, both for patients with multidrug resistance (MDR-TB) and TB with pre-extensive drug resistance (pre-XDR-TB), is high: "successful treatment" 88,1-95,3 %. The tolerability and safety of mSTR of different composition and duration for patients with MDR-TB were studied. Among the 9-month regimens, the regimen with moxifloxacin (mSTR-2) had the best tolerability – the number of adverse events (AE) was 27,9 %, among the 6-month mSTR-7 (BPaLM) – AE in 16,7 %. The tolerability and safety of mSTR of different composition and duration for patients with extensively drug-resistant TB (XDR-TB) were studied. It was established that mSTR-6 based on delamanid was better tolerated for patients with XDR-TB, the total number of AE was 11,8 % compared to the BPaL. The cost-effectiveness was calculated and the optimal composition and duration of mSTR for patients on drug-TB was determined. Among 9-month mSTR for MDR-TB, mSTR-2 based on moxifloxacin has the best cost-effectiveness indicator, among 6-month mCRL for MDR-TB – mSTR-7 based on pretomanid, among 6-month mSTR for pre-XDR-TB – mSTR-5 based on pretomanid. The technology of optimal use of the BPaL regimen to achieve its max efficiency was developed, which made it possible to achieve a high efficiency of treatment patients with pre-XDR-TB – 91,5 %. Sphere of application – tuberculosis.
Barbova Anna I
Veselovsʹkyy Leonid V
Hritsova Nataliya A
Davydenko Valentyna V
Zhurylo Oleksandr A.
Zaikov Serhii V.
Korotchenko Svitlana P
Lafeta Anastasiya S
Lytvynenko Nataliya A
Lyubevych Rostyslav L
Pyrog Alla I
Pohrebna Maryna V
Polinovskaya Lesia V
Protsyk Lyubomyr M
Siomak Olga V
Senko Yuliia O
Tsapyk Oksana O
Chobotar Oksana P
Shcherbakova Lesya V
Yalenko Viktoriia M
2023-12-31
Updated: 2025-12-19
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