title: Extensively drug-resistant tuberculosis treatment outcome in Iran: a case series of seven patients.
abstract: 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.
authors.affiliation: Department of TB and Respiratory Infection, National Research Institute of TB and Lung Disease, Masih Daneshvari Hospital, Niavaran-Darabad, Tehran, Iran.
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Masjedi
authors.forename: Payam
authors.initials: P
authors.lastname: Tabarsi
authors.forename: Parvaneh
authors.initials: P
authors.lastname: Baghaei
authors.forename: Sara
authors.initials: S
authors.lastname: Jalali
authors.forename: Parisa
authors.initials: P
authors.lastname: Farnia
authors.forename: Ehsan
authors.initials: E
authors.lastname: Chitsaz
authors.forename: Majid
authors.initials: M
authors.lastname: Amiri
authors.forename: Davood
authors.initials: D
authors.lastname: Mansouri
authors.forename: Ali A
authors.initials: AA
authors.lastname: Velayati
mesh_terms: 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
chemical_list: D000995:Antitubercular Agents