The Efficacy of Bedaquiline Versus Kanamycin in Multi-drug Resistant Tuberculosis: A Systematic Scoping Review

Overview

Journal Health SA

Specialty Health Services

Date 2021 Dec 17

PMID 34917407

Authors

Lisa Singh

Lehlohonolo J Mathibe

Varsha Bangalee

Affiliations

Soon will be listed here.

Abstract

Background: Drug-resistant tuberculosis (DR-TB) has become a serious cause of concern both on a global scale and in South Africa. It is associated with a lower successful treatment rate, thus creating a hurdle in achieving good treatment outcomes for patients.

Aim: The aim of this study was to compare the efficacy of the drug kanamycin, an injectable aminoglycoside, to bedaquiline, a newer oral drug used to treat DR-TB.

Methods: PubMed and Google Scholar, both of which are online databases, were extensively searched using the necessary keywords so that studies that were relevant to the scoping review were retrieved. A data-charting list was developed to extract the needed data for this scoping review.

Results: The main findings of the scoping review showed that bedaquiline was highly efficacious in the treatment of DR-TB, and that it was a valuable addition in the treatment of DR-TB. The findings of the study also showed that kanamycin does not have good efficacy against DR-TB. and its use extends the treatment of DR-TB.

Conclusion: It stands to reason that bedaquiline replaces kanamycin in the DR-TB drug regimen as it was shown to be more efficacious and patients experienced better treatment outcomes in a shorter period of time. There were also fewer adverse effects associated with bedaquiline as compared to kanamycin.

Contribution: Bedaquiline-based DR-TB therapy is more efficacious than aminoglycoside-based regimens which include kanamycin.

References

Keshavjee S, Farmer P . Tuberculosis, drug resistance, and the history of modern medicine. N Engl J Med. 2012; 367(10):931-6. DOI: 10.1056/NEJMra1205429. View

Serio A, Keepers T, Andrews L, Krause K . Aminoglycoside Revival: Review of a Historically Important Class of Antimicrobials Undergoing Rejuvenation. EcoSal Plus. 2018; 8(1). PMC: 11575671. DOI: 10.1128/ecosalplus.ESP-0002-2018. View

Cegielski J, Chan P, Lan Z, Udwadia Z, Viiklepp P, Yim J . Aminoglycosides and Capreomycin in the Treatment of Multidrug-resistant Tuberculosis: Individual Patient Data Meta-analysis of 12 030 Patients From 25 Countries, 2009-2016. Clin Infect Dis. 2020; 73(11):e3929-e3936. PMC: 8653626. DOI: 10.1093/cid/ciaa621. View

Barvaliya S, Desai M, Panchal J, Solanki R . Early treatment outcome of bedaquiline plus optimised background regimen in drug resistant tuberculosis patients. Indian J Tuberc. 2020; 67(2):222-230. DOI: 10.1016/j.ijtb.2020.03.002. View

Peters M, Godfrey C, Khalil H, McInerney P, Parker D, Soares C . Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015; 13(3):141-6. DOI: 10.1097/XEB.0000000000000050. View

Reuter A, Tisile P, von Delft D, Cox H, Cox V, Ditiu L . The devil we know: is the use of injectable agents for the treatment of MDR-TB justified?. Int J Tuberc Lung Dis. 2017; 21(11):1114-1126. DOI: 10.5588/ijtld.17.0468. View

Bastard M, Molfino L, Mutaquiha C, Galindo M, Zindoga P, Vaz D . Treatment Outcomes of Patients Switching From an Injectable Drug to Bedaquiline During Short Standardized Treatment for Multidrug-resistant Tuberculosis in Mozambique. Clin Infect Dis. 2019; 69(10):1809-1811. DOI: 10.1093/cid/ciz196. View

Olaru I, Heyckendorf J, Andres S, Kalsdorf B, Lange C . Bedaquiline-based treatment regimen for multidrug-resistant tuberculosis. Eur Respir J. 2017; 49(5). DOI: 10.1183/13993003.00742-2017. View

Gualano G, Capone S, Matteelli A, Palmieri F . New Antituberculosis Drugs: From Clinical Trial to Programmatic Use. Infect Dis Rep. 2016; 8(2):6569. PMC: 4927937. DOI: 10.4081/idr.2016.6569. View

10.

van Altena R, Dijkstra J, van der Meer M, Borjas Howard J, Kosterink J, van Soolingen D . Reduced Chance of Hearing Loss Associated with Therapeutic Drug Monitoring of Aminoglycosides in the Treatment of Multidrug-Resistant Tuberculosis. Antimicrob Agents Chemother. 2017; 61(3). PMC: 5328543. DOI: 10.1128/AAC.01400-16. View

11.

Zhao Y, Fox T, Manning K, Stewart A, Tiffin N, Khomo N . Improved Treatment Outcomes With Bedaquiline When Substituted for Second-line Injectable Agents in Multidrug-resistant Tuberculosis: A Retrospective Cohort Study. Clin Infect Dis. 2018; 68(9):1522-1529. PMC: 6481989. DOI: 10.1093/cid/ciy727. View

12.

Wang M, Huang W, Wang Y, Zhang Y, Zhang M, Wu S . Association between tobacco smoking and drug-resistant tuberculosis. Infect Drug Resist. 2018; 11:873-887. PMC: 6003534. DOI: 10.2147/IDR.S164596. View

13.

Alagna R, Besozzi G, Codecasa L, Gori A, Migliori G, Raviglione M . Celebrating World Tuberculosis Day at the time of COVID-19. Eur Respir J. 2020; 55(4). PMC: 7113797. DOI: 10.1183/13993003.00650-2020. View

14.

Ahmad N, Ahuja S, Akkerman O, Alffenaar J, Anderson L, Baghaei P . Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis. Lancet. 2018; 392(10150):821-834. PMC: 6463280. DOI: 10.1016/S0140-6736(18)31644-1. View

15.

Sarin R, Singla N, Vohra V, Singla R, Puri M, Munjal S . Initial experience of bedaquiline implementation under the National TB Programme at NITRD, Delhi, India. Indian J Tuberc. 2019; 66(1):209-213. DOI: 10.1016/j.ijtb.2019.02.009. View

16.

Dookie N, Rambaran S, Padayatchi N, Mahomed S, Naidoo K . Evolution of drug resistance in Mycobacterium tuberculosis: a review on the molecular determinants of resistance and implications for personalized care. J Antimicrob Chemother. 2018; 73(5):1138-1151. PMC: 5909630. DOI: 10.1093/jac/dkx506. View

17.

Mpobela Agnarson A, Wang X, Potluri R, Bhandari H, Dhir A, Kambili C . Long-term impact of the adoption of bedaquiline-containing regimens on the burden of drug-resistant tuberculosis in China. BMC Infect Dis. 2020; 20(1):113. PMC: 7011376. DOI: 10.1186/s12879-020-4795-4. View

18.

Guglielmetti L, Le Du D, Jachym M, Henry B, Martin D, Caumes E . Compassionate use of bedaquiline for the treatment of multidrug-resistant and extensively drug-resistant tuberculosis: interim analysis of a French cohort. Clin Infect Dis. 2014; 60(2):188-94. DOI: 10.1093/cid/ciu786. View

19.

Lange C, Aarnoutse R, Alffenaar J, Bothamley G, Brinkmann F, Costa J . Management of patients with multidrug-resistant tuberculosis. Int J Tuberc Lung Dis. 2019; 23(6):645-662. DOI: 10.5588/ijtld.18.0622. View