Compliance with new drug use and the effect of discrepant drug susceptibility testing on MDR/RR-TB treatment-Reference-Cited by-同舟云学术

Compliance with new drug use and the effect of discrepant drug susceptibility testing on MDR/RR-TB treatment

Published:2024-02-01 Issue:2 Volume:28 Page:86-92
ISSN:1027-3719
Container-title:The International Journal of Tuberculosis and Lung Disease
language:en
Short-container-title:int j tuberc lung dis

Author:

Shin J. E.¹,Jeon D.²,Mok J.³,Yim J-J.⁴,Kwon Y-S.⁵,Jo K-W.⁶,Shim T. S.⁶

Affiliation:

1. Division of Pulmonary and Critical Care Medicine, Asan Medical Center, Seoul,

2. Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan,

3. Department of Internal Medicine, Pusan National University Hospital, Busan,

4. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul,

5. Department of Internal Medicine, Chonnam National University Hospital, Gwangju,

6. Division of Pulmonary and Critical Care Medicine, Asan Medical Center, Seoul, Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea

Abstract

<sec id="st1"><title>BACKGROUND</title>Following the WHO’s announcement in 2018, the use of new drugs was recommended for all patients with multidrug-resistant TB (MDR-TB) in Korea. This study aimed to evaluate adherence to new anti-TB drug regimens and implementation of molecular drug susceptibility testing (mDST) in Korea.</sec><sec id="st2"><title>METHODS</title>Nationwide, 560 patients were reported as having MDR-TB in 2021. The implementation of mDST and new anti-TB drug use were analysed. The discrepancy between mDST and phenotypic DST (pDST) results and their implications on the use of new anti-TB drugs were also analysed. The use of novel anti-TB drugs has been approved by the National TB Expert Committee.</sec><sec id="st3"><title>RESULTS</title>The non-adherence rate in MDR-TB patients was 14.3%. The mDST implementation rate was 96.1%. Of the 459 patients who underwent both mDST and pDST, the discordance rate for rifampicin (RIF) resistance was 22.6% (n = 104), of which 72.1% (n = 75) were resistant on mDST but susceptible on pDST. The discrepancy in mDST and pDST results related to RIF resistance was found to be the main cause of non-adherence to new drug regimen.</sec><sec id="st4"><title>CONCLUSION</title>Comprehensive training on how to interpret conflicting results between mDST and pDST could enhance the utilisation of new drugs in the treatment of MDR/RIF-resistant TB.</sec>

Publisher

International Union Against Tuberculosis and Lung Disease