The effectiveness of the introduction of the updated treatment regimens and microbiological diagnostics MDR/XDR tuberculosis

In Russia the implementation of the latest WHO TB treatment recommendations were started, by issuing of the Executive order #951 of the Ministry of Health of the Russian Federation (MoH) in 2015. <b>Aim:</b> To compare the effectiveness of chemotherapy in patients with MDR/XDR-TB before and after the introduction of the updated treatment regimens and express methods of microbiological diagnostics established by the Executive order #951. <b>Methods:</b> The results of treatment of patients (n=378) treated in 2014 and 2018 (years before and after the implementation of the recommendations of WHO, MoH Executive order #951) were compared. <b>Results:</b> According to the clinical characteristics of tuberculosis of new MDR/XDR-TB cases admitted for treatment in 2018 were more severe (compared to 2014), and the results of treatment were better. Thus, as per the cessation of bacilli excretion termination by sputum smear microscopy in 2018 was 91.7% (in 2014 - 75%), the frequency of bacterial excretion termination by sowing in the culture in 2018 was 90.9% (in 2014 it was only 77.3%). A similar difference in this indicator was observed in patients with the relapse. Overall TB patient’s tolerability of the updated treatment regimens was satisfactory. In the treatment process, prolongation of the QTс interval (in the range of 450-500) was observed in 29.7% patients, it was not accompanied by clinical manifestations. At the end of treatment of the bedaquiline prolonged QT interval remained only in 8.3% patients. <b>Conclusion:</b> Тhe introduction of the updated regimens and express methods of microbiological diagnostics have improved the efficiency of treating the patients with MDR/XDR-TB.