Efficacy of Bedaquiline in the Management of Multidrug-Resistant Tuberculosis in the Central African Republic

Résumé fourni par la source

Multidrug-resistant tuberculosis (MDR-TB) poses a major challenge in the Central African Republic (CAR), as the high incidence of tuberculosis and resistance rates to anti-tuberculosis drugs compromise efforts to manage MDR/RR-TB patients. This study evaluates the efficacy of bedaquiline, integrated into the short BPaLM regimen (Bedaquiline-Pretomanid-Linezolid-Moxifloxacin), in 68 patients with MDR-TB or pre-extensively drug-resistant (pre-XDR) TB. Strains from the National Reference Laboratory of Bangui underwent whole-genome sequencing and in silico resistance analysis. Among the participants (mean age: 32 years; 60.29% male), 82.35% had MDR-TB and 4.42% had pre-XDR TB. All strains were sensitive to bedaquiline, with no mutation detected in the atpC gene. Of the 59 patients treated, 57 (96.6%) successfully completed the 9-month protocol, confirmed by a negative culture at month 21. Two deaths, occurring before the start of treatment (due to a drug stockout), were not attributable to the treatment regimen. These results demonstrate exceptional efficacy of bedaquiline in a real-world setting, with a 100% therapeutic success rate among patients who received the treatment. The study underscores the importance of continuous access to medications and supports adopting the BPaLM regimen in CAR to improve MDR/RR-TB management. These findings support the integration of bedaquiline into national strategies, aligned with WHO objectives for tuberculosis elimination.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.