Treatment Outcomes in Low-Level Isoniazid Resistant Tuberculosis
Notice bibliographique
Résumé
Background. Isoniazid (INH) is an important drug in the treatment of Mycobacterium tuberculosis (TB). Resistance to INH is classified as either high-level (MIC >2 µg/mL) or low-level (MIC 0.2–1 µg/mL) resistance. Treatment of high-level resistant TB usually requires discontinuation of INH and, either a more prolonged treatment course, or a greater number of drugs in the continuation phase. Some evidence suggests that including INH in the treatment regimens of low-level resistant strains may be acceptable, as resistance can be overcome when high serum concentrations of INH are achieved. A retrospective study was conducted on all cases of low-level INH resistant TB in Alberta, Canada. The purpose was to determine whether treatment with conventional INH-containing regimens was associated with a higher rate of treatment failure. Methods. All cases of low-level INH resistant TB in Alberta between 1992 and 2012 were identified using a provincial TB surveillance database. Cases were stratified into two groups based on whether the treatment regimen included INH for the entire duration of therapy or an alternative non-INH containing regimen was used. Data on baseline characteristics of the two groups were obtained, including site of disease, sex, age, country of origin, HIV status and previous TB treatment. The mean duration of therapy in the two groups was determined. Treatment failure was defined as disease relapse at one year through passive surveillance. Results. Thirty-one cases of low-level INH resistant TB were identified, of which 10 were INH treated and 21 were non-INH treated. There was no difference between the two groups with respect to baseline characteristics. The mean duration of treatment in the INH group was significantly shorter than the non-INH group (8.5 versus 12.9 months) (p = 0.004). One patient was lost to follow up in each group due to relocation from the province. There were no cases of disease relapse identified at one year. Conclusion. This study supports the use of first line INH-containing regimens in TB cases with low-level INH resistance. Patients who receive INH may receive shorter courses of therapy without an apparent increased risk of early disease relapse. Larger prospective studies are required to further support these findings. Disclosures. All authors: No reported disclosures.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».