To assess the efficacy and safety of various treatment regimens for drug-resistant tuberculosis (DR-TB) across different geographical regions and drug resistance patterns, highlighting the importance of understanding regional differences.
Key Findings:
The global pooled prevalence of MDR-TB is 11.6%, with XDR-TB prevalence at 2.5%.
The treatment success rate for MDR/RR-TB improved to 68% in 2024, up from 50% in 2012, indicating significant progress but still highlighting the need for improved outcomes.
Adverse events during treatment include nausea, vomiting, gastrointestinal diseases, and mental disorders, which can impact treatment adherence and patient quality of life.
Interpretation:
Despite improvements in treatment success rates, the overall prognosis for DR-TB remains poor, with significant adverse events reported across treatment regimens, necessitating careful consideration of treatment options.
Limitations:
Limited comparative evidence on the efficacy and safety of DR-TB treatment strategies across different regions, which may affect generalizability.
Variability in study quality and reporting standards among included studies, potentially introducing bias in the findings.
Conclusion:
The systematic review highlights the need for more comprehensive studies to better understand the efficacy and safety of DR-TB treatment regimens globally, particularly in high-burden regions.
Amoxicillin-clavulanate was not linked to lower treatment failure but was associated with a slightly higher risk of secondary infections compared with amoxicillin in adults with uncomplicated acute sinusitis.
