TABLE 7

Summary of the characteristics and evolution of patients who died or experienced treatment failure

PatientOutcomeTB diagnosisInitial treatment regimenDescription
1Treatment failureExtended pulmonary XDR-TBBDQ, AM, ETO, PAS, LZD, CFZLZD, PAS and AM had to be stopped because of peripheral neuropathy, gastrointestinal intolerance and hearing loss. After achieving initial culture conversion, the patient reverted to sputum culture-positive at 14 months of treatment, acquiring resistance to BDQ.
2DeathExtended pulmonary MDR-TBAM, MFX, CS, PAS, LZD, CFZThe patient died from dissemination of a pharyngolaryngeal cancer after 9 months of treatment. BDQ was started at month 4 and stopped at month 5 because of QTcF interval prolongation.
3DeathExtended pulmonary XDR-TBBDQ, CS, PAS, LZD, IPM/CLN, AMX/CLVThe patient achieved sputum culture conversion at month 4 of treatment. At month 15 of treatment, he developed peripheral neuropathy, difficulty swallowing, myositis, myoclonia and psychiatric disorders. He died 1 month later with no obvious diagnosis. No signs of serotonin syndrome were present and the patient did not receive any serotonin-inducing concomitant medication. Autopsy found no explanation for the death.
4DeathExtended pulmonary XDR-TBBDQ, AM, PAS, LZD, IPM/CLN, AMX/CLVThe patient achieved sputum culture conversion at month 4 of treatment, after performing lung surgery. From month 9 of treatment, he gradually developed peripheral neuropathy and neuropsychiatric disorders. After a septic shock due to catheter infection at month 21, he was diagnosed with polyradiculoneuropathy and brainstem disorder. He died a few days later. No signs of serotonin syndrome were present and the patient did not receive any serotonin-inducing concomitant medication. Autopsy was not performed.
5Death (during follow-up)Extended pulmonary XDR-TBBDQ, CM, MFX, CFZ, LZD, IPM/CLN, AMX/CLVThe patient underwent lung surgery at month 1 and was declared cured after 19 months of treatment. He died of an overdose of recreational drugs 1 month after the end of treatment.
6Death (during follow-up)Extended pulmonary XDR-TBBDQ, E, Z, AM, MFX, PAS, LZDThe patient suffered from type 1 diabetes and chronic renal insufficiency. He was declared cured after 18 months of treatment and had no sign of recurrence. He died of terminal renal failure 20 months after the end of treatment.
  • TB: tuberculosis; XDR: extensively drug-resistant; MDR: multidrug-resistant; BDQ: bedaquiline; AM: amikacin; ETO: ethionamide; PAS: p-aminosalicylic acid; LZD: linezolid; CFZ: clofazimine; MFX: moxifloxacin; CS: cycloserine; IPM/CLN: imipenem/cilastatin; AMX/CLV: amoxicillin/clavulanic acid; CM: capreomycin; E: ethambutol; Z: pyrazinamide; QTcF: Fridericia-corrected QT interval.