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A systematic review of clinical outcomes on the WHO Category II retreatment regimen for tuberculosis.

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Cohen, Danielle, Meghji, J and Squire, Bertie ORCID: https://orcid.org/0000-0001-7173-9038 (2018) 'A systematic review of clinical outcomes on the WHO Category II retreatment regimen for tuberculosis.'. International Journal of Tuberculosis and Lung Disease, Vol 22, Issue 10, pp. 1127-1134.

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Abstract

OBJECTIVE

To assess the clinical outcomes of patients prescribed the World Health Organization (WHO) Category II retreatment regimen for tuberculosis (TB).

DESIGN
A systematic review of the literature was performed by searching Medscape, Embase and Scopus databases for cohort studies and clinical trials reporting outcomes in adult patients on the Category II retreatment regimen.

RESULTS
The proportion of patients successfully completing the retreatment regimen varied from 27% to 92% in the 39 studies included in this review. In only 2/39 (5%) studies was the treatment success rate > 85%. There are very few data concerning outcomes in patients categorised as 'other', and outcomes in this subgroup are variable. Of the five studies reporting disaggregated outcomes in human immunodeficiency virus (HIV) positive people, four demonstrated worse outcomes than in HIV-negative people on the retreatment regimen. Only four studies reported disaggregated outcomes in patients with isoniazid (INH) resistance, and treatment success rates varied from 11% to 78%.

CONCLUSION
Clinical outcomes on the Category II retreatment regimen are poor across various populations. Improvements in management should consider the holistic treatment of comorbidity and comprehensive approaches to drug resistance in patients with recurrent TB, including a standardised approach for the management of INH resistance in patients who develop recurrent TB in settings without reliable access to comprehensive drug susceptibility testing.

Item Type: Article
Subjects: WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WF Respiratory System > Tuberculosis > WF 310 Therapy
WF Respiratory System > Tuberculosis > WF 360 Drug therapy
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.5588/ijtld.17.0705
Depositing User: Stacy Murtagh
Date Deposited: 26 Sep 2018 09:39
Last Modified: 26 Sep 2018 09:39
URI: http://archive.lstmed.ac.uk/id/eprint/9368

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