Long-term results of chemotherapy of tuberculosis with a widespread drug-resistant pathogen using bedaquiline

Relevance. Long-term results of treatment of patients with widespread drug-resistant tuberculosis are not presented in the medical literature. Objective. Study the efficacy and long-term results of treatment of patients with widespread drug-resistant tuberculosis using bedaquiline. Material and methods. Two groups of patients with widespread drug-resistant tuberculosis were formed, who received bedaquiline as the base drug of the chemotherapy course: bedaquiline in the main group (49 people) and moxifloxacin in the control group (76 people). The results of treatment at the end of the course of chemotherapy and after three years of follow-up were studied. Results. 87.8±9.2% of patients from the main group completed an effective course of treatment with sputum culture control. In 67.3±13.1%, the cessation of bacillus excretion was achieved at 1–2 months of treatment. Undesirable effects of chemotherapy were noted in 10.2–32.7% of cases, with prolongation of the QT interval only in 8.2±7.7% of patients. After a three-year dispensary follow-up, there was no recurrence of tuberculosis in the main group, chronic obstructive pulmonary disease was less common for the fifirst time, no cases of treatment by a cardiologist and gynecologist were found, the transfer of patients from the second disability group to the third was more often observed. Conclusion. The use of bedaquiline for the treatment of patients with widespread drug-resistant tuberculosis makes it possible to achieve early cessation of bacillus excretion with transfer to outpatient treatment, reduce the frequency of adverse reactions of chemotherapy. The long-term results of dispensary observation indicate a low risk of reactivation of tuberculosis, a significant reduction in the need for dispensary observation by other specialists, including a cardiologist, and improvement in the results of complex rehabilitation.