TY - JOUR
T1 - Efficacy, safety, and tolerability of a 24-month treatment regimen including delamanid in a child with extensively drug-resistant tuberculosis
T2 - A case report and review of the literature
AU - Esposito, Susanna
AU - Bosis, Samantha
AU - Tadolini, Marina
AU - Bianchini, Sonia
AU - Migliori, Giovanni Battista
AU - Principi, Nicola
PY - 2016/11/1
Y1 - 2016/11/1
N2 - RATIONAL: Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) are emerging problems in several countries. These infections require long and expensive treatment regimens. Recently, 2 new drugs, bedaquiline and delamanid, have been approved in several countries for use in adults with severe, difficult-to-treat MDR-TB, and it has been suggested that they could also be administered to children with MDR-TB and limited treatment options. However, no study has been completed on their efficacy.PATIENT CONCERNS: This report describes a 12-year-old child with XDR-TB who was cured after a 24-month therapy regimen, which included delamanid.DIAGNOSES: The patient showed progressive clinical deterioration after 5 months of treatment with the majority of anti-TB drugs available on the market.INTERVENTIONS: After unsuccessfull treatment with several anti-TB drugs for 5 months, he was treated with a regimen including for 24 months.OUTCOMES: Direct smear microscopy of the gastric aspirates and gastric aspirate cultures for Mycobacterium tuberculosis became negative after only 1 week and remained persistently negative. During the 24-month treatment, all blood test results remained within the normal range, no adverse events were reported, and corrected QT interval was always normal. A clinical and laboratory control was performed 3 months after discontinuation of delamanid, and the other drugs did not reveal any modification of both general conditions as well as laboratory and radiological findings. The patient was considered cured.LESSONS: The positive outcome associated with the favorable safety and tolerability profile showed that long-term therapy with delamanid can significantly contribute to treating apparently hopeless XDR-TB cases in children.
AB - RATIONAL: Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) are emerging problems in several countries. These infections require long and expensive treatment regimens. Recently, 2 new drugs, bedaquiline and delamanid, have been approved in several countries for use in adults with severe, difficult-to-treat MDR-TB, and it has been suggested that they could also be administered to children with MDR-TB and limited treatment options. However, no study has been completed on their efficacy.PATIENT CONCERNS: This report describes a 12-year-old child with XDR-TB who was cured after a 24-month therapy regimen, which included delamanid.DIAGNOSES: The patient showed progressive clinical deterioration after 5 months of treatment with the majority of anti-TB drugs available on the market.INTERVENTIONS: After unsuccessfull treatment with several anti-TB drugs for 5 months, he was treated with a regimen including for 24 months.OUTCOMES: Direct smear microscopy of the gastric aspirates and gastric aspirate cultures for Mycobacterium tuberculosis became negative after only 1 week and remained persistently negative. During the 24-month treatment, all blood test results remained within the normal range, no adverse events were reported, and corrected QT interval was always normal. A clinical and laboratory control was performed 3 months after discontinuation of delamanid, and the other drugs did not reveal any modification of both general conditions as well as laboratory and radiological findings. The patient was considered cured.LESSONS: The positive outcome associated with the favorable safety and tolerability profile showed that long-term therapy with delamanid can significantly contribute to treating apparently hopeless XDR-TB cases in children.
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M3 - Article
C2 - 27861363
AN - SCOPUS:85011977124
VL - 95
SP - e5347
JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries
JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries
SN - 0025-7974
IS - 46
ER -