Extensively drug-resistant tuberculosis treatment outcome in Iran: a case series of seven patients.
BACKGROUND
Extensively drug-resistant tuberculosis (XDR-TB) has recently been identified as a major threat to global health. XDR-TB poses a risk of higher failure rates and death during TB treatment. We report herein the outcomes of XDR-TB in patients treated with the standardized regimen in Iran.


METHODS
Between 2002 and 2006, seven patients were diagnosed with XDR-TB. All patients were treated with the standardized second-line regimen containing cycloserine, prothionamide, amikacin, and ofloxacin. First-line drugs, such as ethambutol and pyrazinamide, were added to the regimen if drug susceptibility testing showed sensitivity to these drugs.


RESULTS
Four (57.1%) patients were male. All seven patients were HIV-negative. The patient age range was 22-79 years. Of the seven cases, the final outcome was 'cure' in two (28.6%), 'relapse' in one, 'treatment failure' in one, and 'death' in two; the outcome for one patient was unknown.


CONCLUSIONS
Our study shows a poor prognosis in patients with XDR-TB. This indicates the necessity of detecting XDR-TB cases earlier, as well as the need to gain access to more second-line agents. This is particularly important in resource-limited settings in order to administer individualized regimens.
Masjedi
Mohammad R
MR
Department of TB and Respiratory Infection, National Research Institute of TB and Lung Disease, Masih Daneshvari Hospital, Niavaran-Darabad, Tehran, Iran.
Tabarsi
Payam
P
Baghaei
Parvaneh
P
Jalali
Sara
S
Farnia
Parisa
P
Chitsaz
Ehsan
E
Amiri
Majid
M
Mansouri
Davood
D
Velayati
Ali A
AA
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D055815:Young Adult
D000995:Antitubercular Agents