Use of bedaquiline in the treatment of a patient with extensively drug-resistant pulmonary tuberculosis
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Respiratory Infections Unit, Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Exohi, Thessaloniki, Greece
TB Department, Sotiria Chest Diseases Hospital, Athens, Greece
National Reference Center for Mycobacteria, Sotiria Chest Diseases Hospital, Athens, Greece
Katerina Manika   

“G. Papanikolaou” Hospital, 57010 Exohi, Thessaloniki
Publication date: 2021-06-17
Pneumon 2016;29(1):53–57
A 27-year-old man from the former Soviet Union with unremarkable medical history was diagnosed with pulmonary tuberculosis and was initially treated with the standard antituberculosis regimen (R, H, E, Z). Based on the sputum molecular analysis for M. tuberculosis the diagnosis of multidrug-resistant tuberculosis (MDR-TB) at first and later of extensively drug-resistant tuberculosis (XDR-TB) was made. The patient received a complex antituberculosis regimen, which included ethionamide, pyrazinamide, capreomycin, imipenem /cilastatin, linezolid and an increased dose of moxifloxacin at 600 mg. Due to the limited number of drugs that were active in vitro in the above regimen, bedaquiline was added for six months, and moxifloxacin was discontinued. The patient showed significant clinical and radiological improvement, increase in body weight, reduction of his cavities’ size and culture conversion, without severe side effects. After one year of hospitalization, the patient was discharged on a regimen of capreomycin, linezolid, clofazimine, pyrazinamide, ethionamide and moxifloxacin and is still followed up in the outpatient clinic for tuberculosis of AUTH’s Pulmonary Department on a weekly basis. Treatment time is estimated at 18 months after culture conversion.
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