Treatment outcomes and medication management of tuberculosis

Tuberculosis (TB) is a bacterial infectious disease. The majority of TB patients in the Netherlands are successfully treated but in some patientsextension of treatment duration is necessary due to complications. Only in a small number of patients this treatment fails. This thesis focuses on the multifaceted medical approach to optimize the treatment of TB and improve treatment outcomes.In the first part of this thesis, we used long-term data from the national tuberculosis registry to determine the risk factors of prolonged and unsuccessful TB treatment in different patients. By identifying risk factors at an early stage, appropriate measures can be taken to reduce their impact and improve TB treatment outcomes. In the second part of this thesis, we evaluated the efficacy of a well-known antibiotic called levofloxacin. We investigated the relationship between the amount of antibiotic in the blood and the effectiveness of the treatment, and side effects by combining and analyzing data from previous studies. We also investigated in patients with a highly resistant form of TB whether they had enough of the antibiotic in their blood to kill the bacteria.Based on this research, we conclude that the amount of antibiotic in the blood differs per patient, and monitoring of this value combined with measuring the sensitivity of the bacteria to the antibiotic is necessary to adjust the dosage and thereby optimize treatment.