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Drug resistant TB: UK multicentre study (drums): Treatment, management and outcomes in London and West Midlands 2008-2014.

Arnold, A; Cooke, GS; Kon, OM; Dedicoat, M; Lipman, M; Loyse, A; Butcher, PD; Ster, IC; Harrison, TS (2017) Drug resistant TB: UK multicentre study (drums): Treatment, management and outcomes in London and West Midlands 2008-2014. J Infect, 74 (3). pp. 260-271. ISSN 1532-2742 https://doi.org/10.1016/j.jinf.2016.12.005
SGUL Authors: Butcher, Philip David Chis Ster, Delizia Irina Loyse, Angela

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Abstract

OBJECTIVES: Detailed information regarding treatment practices and outcomes of MDR-TB treatment in the UK is required as a baseline for care improvements. METHODS: 100 consecutive cases between 2008 and 2014 were reviewed retrospectively at 4 MDR-TB treatment centres in England to obtain information on drug treatment choices, hospital admission duration and outcomes for MDR-TB. RESULTS: Initial hospital admission was long, median 62.5 (IQR 20-106, n = 92) days, and 13% (12/92) of patients lost their home during this period. Prolonged admission was associated with pulmonary cases, cavities on chest radiograph, a public health policy of waiting for sputum culture conversion (CC) and loss of the patient's home. Sputum CC occurred at a median of 33.5 (IQR 16-55, n = 46) days. Treatment success was high (74%, 74/100) and mortality low (1%, 1/100). A significant proportion of the cohort had "neutral" results due to deportation and transfer overseas (12%, (12/100)). 14% (14/100) had negative outcomes for which poor adherence was the main reason (62%, 9/14). CONCLUSIONS: Successful outcome is common in recognised centres and limited by adherence rather than microbiological failure. Duration of hospital admission is influenced by lack of suitable housing and some variation in public health practice. Wider access to long-term assisted living facilities could improve completion rates.

Item Type: Article
Additional Information: © 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Tuberculosis, Microbiology, 1103 Clinical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: J Infect
ISSN: 1532-2742
Language: eng
Dates:
DateEvent
1 March 2017Published
18 December 2016Published Online
8 December 2016Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
PubMed ID: 27998752
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/108519
Publisher's version: https://doi.org/10.1016/j.jinf.2016.12.005

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