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Drug resistant TB: UK multicentre study (drums): Treatment, management and outcomes in London and West Midlands 2008-2014

Arnold, A; Cooke, GS; Kon, OM; Dedicoat, M; Lipman, M; Loyse, A; Butcher, PD; ... Harrison, TS; + view all (2017) Drug resistant TB: UK multicentre study (drums): Treatment, management and outcomes in London and West Midlands 2008-2014. Journal of Infection , 74 (3) pp. 260-271. 10.1016/j.jinf.2016.12.005. Green open access

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Abstract

OBJECTIVES: Detailed information regarding treatment practices and outcomes of MDR-TB treatment in the UK is required as a baseline for care improvements. METHODS: 100 consecutive cases between 2008 and 2014 were reviewed retrospectively at 4 MDR-TB treatment centres in England to obtain information on drug treatment choices, hospital admission duration and outcomes for MDR-TB. RESULTS: Initial hospital admission was long, median 62.5 (IQR 20-106, n = 92) days, and 13% (12/92) of patients lost their home during this period. Prolonged admission was associated with pulmonary cases, cavities on chest radiograph, a public health policy of waiting for sputum culture conversion (CC) and loss of the patient's home. Sputum CC occurred at a median of 33.5 (IQR 16-55, n = 46) days. Treatment success was high (74%, 74/100) and mortality low (1%, 1/100). A significant proportion of the cohort had "neutral" results due to deportation and transfer overseas (12%, (12/100)). 14% (14/100) had negative outcomes for which poor adherence was the main reason (62%, 9/14). CONCLUSIONS: Successful outcome is common in recognised centres and limited by adherence rather than microbiological failure. Duration of hospital admission is influenced by lack of suitable housing and some variation in public health practice. Wider access to long-term assisted living facilities could improve completion rates.

Type: Article
Title: Drug resistant TB: UK multicentre study (drums): Treatment, management and outcomes in London and West Midlands 2008-2014
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jinf.2016.12.005
Publisher version: http://dx.doi.org/10.1016/j.jinf.2016.12.005
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Tuberculosis
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
URI: http://discovery.ucl.ac.uk/id/eprint/1535026
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