title: High Rates of Treatment Success in Pulmonary Multidrug-Resistant Tuberculosis by Individually Tailored Treatment Regimens.
abstract: We evaluated whether treatment outcomes for patients with multidrug-resistant and extensively drug-resistant tuberculosis can be substantially improved when sufficient resources for personalizing medical care are available.
  
  
  
  To describe the characteristics and outcomes of patients with pulmonary multidrug-resistant tuberculosis at the Otto Wagner Hospital in Vienna, Austria.
  
  
  
  We conducted a retrospective single-center study of patients initiated on treatment for multi-drug resistant tuberculosis between January 2003 and December 2012 at the Otto Wagner Hospital, Vienna, Austria. The records of patients with multidrug-resistant tuberculosis were reviewed for epidemiological, clinical, laboratory, treatment, and outcome data.
  
  
  
  Ninety patients with pulmonary multidrug-resistant tuberculosis were identified. The median age was 30 years (interquartile range, 26-37). All patients were of non-Austrian origin, and 70 (78%) came from former states of the Soviet Union. Thirty-nine (43%) patients had multidrug-resistant tuberculosis; 28 (31%) had additional bacillary resistance to at least one second-line injectable drug and 9 (10%) to a fluoroquinolone. Fourteen (16%) patients had extensively drug-resistant tuberculosis. Eighty-eight different drug combinations were used for the treatment of the 90 patients. Surgery was performed on 10 (11.1%) of the patients. Sixty-five (72.2%) patients had a successful treatment outcome, 8 (8.9%) defaulted, 3 (3.3%) died, 8 (8.9%) continued treatment in another country and their outcome was unknown, and 6 (6.7%) were still on therapy. None of the patients experienced treatment failure. Treatment outcomes for patients with extensively drug-resistant tuberculosis were similar to those of patients with multidrug-resistant tuberculosis.
  
  
  
  High rates of treatment success can be achieved in patients with multidrug-resistant and extensively drug-resistant tuberculosis when individually tailored treatment regimens can be provided in a high-resource setting.
authors.affiliation: 1 Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany.|2 German Center for Infection Research, Clinical Tuberculosis Center, Borstel, Germany.
authors.forename: Ioana D
authors.identifier: 0000-0003-3392-9257
authors.initials: ID
authors.lastname: Olaru
authors.affiliation: 1 Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany.|2 German Center for Infection Research, Clinical Tuberculosis Center, Borstel, Germany.|3 International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany.|4 Department of Medicine, Karolinska Institute, Stockholm, Sweden.|5 Department of Internal Medicine, University of Namibia School of Medicine, Windhoek, Namibia.
authors.forename: Christoph
authors.identifier: 0000-0002-9691-4741
authors.initials: C
authors.lastname: Lange
authors.affiliation: 6 Austrian Agency for Health and Food Safety (AGES), Vienna, Austria; and.
authors.forename: Alexander
authors.initials: A
authors.lastname: Indra
authors.affiliation: 6 Austrian Agency for Health and Food Safety (AGES), Vienna, Austria; and.
authors.forename: Liliya
authors.initials: L
authors.lastname: Meidlinger
authors.affiliation: 6 Austrian Agency for Health and Food Safety (AGES), Vienna, Austria; and.
authors.forename: Steliana
authors.initials: S
authors.lastname: Huhulescu
authors.affiliation: 7 Department of Respiratory and Critical Care Medicine, Otto Wagner Hospital, Vienna, Austria.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Rumetshofer
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001317:Austria; D003131:Combined Modality Therapy; D024901:Drug Resistance, Multiple, Bacterial; D054908:Extensively Drug-Resistant Tuberculosis / Q000628:therapy*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008826:Microbial Sensitivity Tests; D015999:Multivariate Analysis; D057285:Precision Medicine / Q000379:methods*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000628:therapy*
chemical_list: D000995:Antitubercular Agents
keywords: drug resistance; multidrug-resistant tuberculosis; outcome; treatment; tuberculosis