August 6, 2008

Drug-Resistant TB Cured in Outpatient Plan

Extensively drug-resistant tuberculosis, or XDR-TB, can be commuted in an individualized outpatient therapy program, researchers in Peru said.

The study, conducted in Peru from 1999 to 2002, showed that more than 60 percent of XDR-TB patients not co-infected with HIV were cured after receiving the bulk of their personalized treatment at home or in community-based settings.

Lead author Carole Mitnick of the Harvard Medical School said that in some parts of the world, however, patients with XDR-TB and other drug-resistant forms of the disease are confined against their will in TB hospitals that resemble prisons.

"It's essential that the world know that XDR-TB is not a death sentence," Mitnick said in a statement. "As or even more importantly, our study shows that effective treatment does not require hospitalization or indefinite confinement of patients."

A total of 810 patients with unsuccessfully treated TB were referred for free individualized drug treatment and additional services as needed, including surgery, adverse-event management and nutritional and psychological support. Based on susceptibility results for 12 anti-TB drugs, clinicians developed regimens that included five or more drugs to treat the infecting strains.

The findings are published in The New England Journal of Medicine.