Treatment outcomes of rifabutin-containing regimens for rifabutin-sensitive multidrug-resistant pulmonary tuberculosis

• Published in: International journal of infectious diseases Vol. 65; pp. 135 - 141
• Main Authors: Lee, Hyun, Ahn, Soohyun, Hwang, Na Young, Jeon, Kyeongman, Kwon, O Jung, Huh, Hee Jae, Lee, Nam Yong, Koh, Won-Jung
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.12.2017; Elsevier
• Subjects: Extensively drug-resistant tuberculosis; Multidrug-resistant tuberculosis; Rifabutin; Treatment outcome; Rifabutin; Treatment outcome; Multidrug-resistant tuberculosis; Extensively drug-resistant tuberculosis
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2017.10.013

•Multidrug-resistant TB (MDR-TB) isolates can be susceptible to rifabutin in vitro.•Use of rifabutin was tested in patients with rifabutin-sensitive MDR-TB.•Rifabutin use was associated with favorable treatment outcomes in these patients.•Rifabutin can improve patient treatment outcomes with rifabutin-sensitive MDR-TB. The aim of this study was to evaluate whether rifabutin can improve treatment outcomes in patients with rifabutin-sensitive MDR-TB. A retrospective cohort study was performed on 76 patients with rifabutin-sensitive MDR-TB who were treated with or without rifabutin between 2006 and 2011. Overall, 75% (57/76) of patients achieved favorable outcomes, including cure (53/76, 70%) and treatment completion (4/76, 5%). In contrast, 25% (19/76) had unfavorable treatment outcomes, which included treatment failure (6/76, 8%), death (2/76, 3%), loss to follow-up (4/76. 5%), and no evaluation due to transfer to other institutions (7/76, 9%). Rifabutin was given to 52 (68%) of the 76 patients with rifabutin-sensitive MDR-TB. Although favorable treatment outcomes were more frequent in patients who received rifabutin [81% (42/52)] than in those who did not receive rifabutin [63% (15/24)], this difference was not statistically significant (P=0.154). However, in multivariable regression logistic analysis, use of rifabutin was significantly associated with favorable treatment outcomes in patients with rifabutin-sensitive MDR-TB (adjusted odds ratio=9.80, 95% confidence interval=1.65–58.37, P=0.012). These results suggest that the use of rifabutin can improve treatment outcomes in patients with rifabutin-sensitive MDR-TB.