@article {Migliori4286, author = {G.B. Migliori and S. Ahuja and D. Ashkin and M. Avendano and R. Banerjee and M. Bauer and J. Bayona and M. Becerra and A. Benedetti and M. Burgos and R. Centis and E.D. Chan and C.-Y. Chiang and H. Cox and L. D{\textquoteright}Ambrosio and K. DeRiemer and N.H. Dung and D. Enarson and K. Flanagan and J. Flood and M.L. Garcia-Garcia and N. Gandhi and R. Granich and M.G. Hollm-Delgado and T.H. Holtz and M. Iseman and L. Jarlsberg and S. Keshavjee and H.R. Kim and W.-J. Koh and J. Lancaster and C. Lange and W.C.M. de Lange and V. Leimane and C.C. Leung and J. Li and S. Mishustin and C. Mitnick and M. Narita and P. O{\textquoteright}Riordan and M. Pai and D. Palmero and S.K. Park and G. Pasvol and J. Pena and C. P{\'e}rez-Guzm{\'a}n and M. Quelapio and A. Ponce-de-Leon and V. Riekstina and J. Robert and S. Royce and H.S. Schaaf and K.J. Seung and L. Shah and T.S. Shim and S.S. Shin and Y. Shiraishi and J. Sifuentes-Osornio and G. Sotgiu and M.J. Strand and P. Tabarsi and T.E. Tupasi and R. van Altena and M. Van der Walt and T.S. Van der Werf and M.H. Vargas and P. Viiklepp and J. Westenhouse and W.W. Yew and J.J. Yim and D. Menzies}, title = {Outcomes for multidrug-resistant tuberculosis patients with and without resistance to fluoroquinolones and second-line injectable drugs: A meta-analysis of individual patient data}, volume = {40}, number = {Suppl 56}, elocation-id = {4286}, year = {2012}, publisher = {European Respiratory Society}, abstract = {Poor treatment outcomes have been reported for tuberculosis (TB) patients harbouring strains resistant to isoniazid and rifampicin (multidrug resistance or MDR-TB), fluoroquinolones and/or second-line injectable drugs.We undertook a meta-analysis for response to treatment using individual data for MDR-TB patients whose strains had additional resistance to fluoroquinolones (MDR-TB+FQ), second-line injectables (MDR-TB+Inj) or both (extensive drug resistance; XDR-TB) including demographic and clinical details, treatment regimens, and outcomes.26 centres provided data for 424 MDR-TB+FQ, 1129 MDR-TB+Inj, 405 XDR-TB, and 4776 other MDR-TB patients susceptible to FQ and Inj. Success was lower in MDR-TB+FQ (adjusted OR=0.6 [95\%CL 0.5-0.7]) and XDR-TB patients (0.4 [0.3-0.6]) than in those with MDR-TB+Inj (0.8 [0.7-0.9]) and those with MDR-TB and no additional resistance (reference). No single drug was significantly associated with treatment success in MDR-TB+FQ and XDR-TB patients. In XDR-TB patients, success was highest if at least 6 drugs were used in the intensive phase (4.9 [1.4-16.6]) and 4 in the continuation phase (6.1[1.4-26.3]).Study results suggest that regimens of a similar duration to those recommended in MDR-TB patients but containing more drugs achieve better results in XDR-TB patients. As all data in the analysis were from observational studies, bias may be substantial and better quality evidence will be needed to guide the optimization of regimens.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/40/Suppl_56/4286}, eprint = {https://erj.ersjournals.com/content/40/Suppl_56/4286.full.pdf}, journal = {European Respiratory Journal} }