Original articleClinical trial of six-month and four-month regimens of chemotherapy in the treatment of pulmonary tuberculosis: The results up to 30 months
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Mind the gap – Managing tuberculosis across the disease spectrum
2022, eBioMedicineCitation Excerpt :These studies were initially conducted in those with smear positive (i.e. extensive/cavitary) pulmonary disease, establishing the 6-month short course regimen; isoniazid and rifampicin supplemented by pyrazinamide and streptomycin (S) for the first 2 months (2SHRZ/4HR) in the first instance (subsequently is was established that streptomycin was not needed as part of this regimen).12 Two year relapse rates were 1–3% with this 6-month regimen and reducing this to 4-months (2SHRZ/2HR) in the smear positive population increased relapse to 8–16%.12–14 Later trials in the 1980’s, conducted by the MRC and Hong Kong Chest Service (HKCS), in smear-negative pulmonary TB demonstrated that in those with lower burden of disease could be effectively treated with the shorter 4-month regimen (Table 1).12,15,16
Modelling the effects of bacterial cell state and spatial location on tuberculosis treatment: Insights from a hybrid multiscale cellular automaton model
2018, Journal of Theoretical BiologyCitation Excerpt :Although a minimum of six months of therapy is recommended, it has long been recognised that many patients require less and are culture negative in two months or less (Fox, 1981). Shortening treatment to four months or less results in unacceptably high relapse rates (Gillespie et al., 2014) and studies (Singapore, 1981; Study, 1981) described in (Fox et al., 1999). It has recently been shown that, for some patients who become culture negative in only a week, there is still a non-zero risk of relapse (Phillips et al., 2016).
pncA mutations are associated with slower sputum conversion during standard treatment of multidrug-resistant tuberculosis
2017, International Journal of Antimicrobial AgentsCitation Excerpt :In 2011, the Chinese health authorities reported an incidence rate of 39.5 per 100,000 individuals nationwide, with 2.3% of primary TB cases being multidrug-resistant (MDR); however, very few MDR-TB cases had drug susceptibility testing (DST) before treatment, in particular testing for pyrazinamide (PZA) susceptibility [2]. The key components of treatment regimens for MDR-TB are second-line drugs (SLDs) and PZA [3,4], which have potent sterilising effects [5,6] thereby enabling a shorter treatment duration [7,8]. Therefore, treatment of MDR-TB may be impaired by resistance to these drugs [9].
Short course treatment regimens for tuberculosis: A review
2015, Journal des Anti-InfectieuxPyrazinamide susceptibility testing of Mycobacterium tuberculosis by high resolution melt analysis
2014, TuberculosisCitation Excerpt :Pyrazinamide (PZA) is a first-line drug for the treatment of tuberculosis. Its use allows shortening of the treatment period from 9 to 6 months and it is also widely included in regimens for MDR-Tb [1–4]. The importance of PZA susceptibility testing has increased due to the recognition of PZA monoresistant strains of Mycobacterium tuberculosis and the need for improved MDR-TB regimens, since some new TB drugs such as bedaquiline appear to benefit from PZA [5,6].
Four-month Moxifloxacin-based regimens for drug-sensitive tuberculosis
2014, New England Journal of MedicineCitation Excerpt :The similarity in outcome among women in the isoniazid group and the control group may represent a chance finding but merits further investigation. It has been previously suggested that Asian patients often have a more chronic form of tuberculosis with a different clinical course than that in African patients,18,19 but we did not see any evidence of variation in clinical-disease outcome in the different racial groups. Our approach in the conduct of this trial, including standardized laboratory methods and clinical management, has resulted in consistent results across more than 20 sensitivity analyses, with minimal variation among study centers on different continents.