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Examples of bedaquiline introduction for the management of multidrug-resistant tuberculosis in five countries | Journal Article / Research | MSF Science Portal
Journal Article
|Research

Examples of bedaquiline introduction for the management of multidrug-resistant tuberculosis in five countries

Guglielmetti L, Hewison CCH, Avaliani Z, Hughes AJ, Kiria N, Lomtadze N, Ndjeka N, Setkina S, Shabangua A, Sikhondze W, Skrahina A, Veziris N, Furin J

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Abstract
BACKGROUND
For the first time in almost 50 years, there are new drugs available for the treatment of tuberculosis (TB), including bedaquiline (BDQ) and delamanid (DLM). The rate of introduction, however, has not kept pace with patient needs. It is estimated that as many as 23% of multidrug-resistant TB (MDR-TB) patients have an indication for receiving BDQ. As this is the first time the MDR-TB community is introducing new medications, it is important to understand how implementation can be developed in a variety of settings.

METHODS
A qualitative assessment of country TB programs in which more than 5% of MDR-TB patients were started on BDQ under program conditions.

RESULTS
National TB programs in Belarus, France, Georgia, South Africa, and Swaziland all started sizeable cohorts of patients on BDQ in 2015. Common factors observed in these programs included experience with compassionate use/expanded access, support from implementing partners, and adequate national or donor-supported budgets. Barriers to introduction included restriction of BDQ to the in-patient setting, lack of access to companion drugs, and the development of systems for pharmacovigilance.

CONCLUSION
The five countries in this paper are examples of the introduction of new therapeutic options for the treatment of TB.

Countries

Belarus Eswatini France Georgia South Africa

Subject Area

antibiotic resistancetuberculosisantimicrobial resistance

Languages

English
DOI
10.5588/ijtld.16.0493
Published Date
01 Feb 2017
PubMed ID
28234080
Journal
International Journal of Tuberculosis and Lung Disease
Volume | Issue | Pages
Volume 21, Issue 2, Pages 167-174
Issue Date
2017-02-01
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