Multidrug-Resistance Seen in ~10 Percent of TB Cases in China

And, a new drug shows significantly improved sputum-culture conversion at two months

WEDNESDAY, June 6 (HealthDay News) -- About one in 10 patients with tuberculosis in China has multidrug-resistant (MDR) tuberculosis; and a new drug, delamanid, is significantly better than placebo for increasing sputum-culture conversion at two months in patients with MDR tuberculosis, according to two studies published in the June 7 issue of the New England Journal of Medicine.

Yanlin Zhao, Ph.D., from the Chinese Center for Disease Control and Prevention in Beijing, and colleagues conducted a national survey of drug resistance in 2007 among 3,037 patients with new cases of tuberculosis and 892 previously treated patients. They found that 5.7 and 25.6 percent, respectively, were MDR (resistant to at least isoniazid and rifampin). About one in four of all patients had tuberculosis that was resistant to isoniazid, rifampin, or both; one in 10 patients had MDR tuberculosis; and extensively drug-resistant tuberculosis was seen in about 8 percent of those with MDR tuberculosis.

In the second study, Maria Tarcela Gler, M.D., from the Makati Medical Center in Manila, Philippines, and colleagues randomly assigned 481 patients with pulmonary MDR tuberculosis to receive delamanid (100 or 200 mg twice a day) or placebo for two months, together with a background regimen of second-line drugs. They found that sputum-culture conversion at two months was significantly higher in the delamanid groups, at 45.4 and 41.9 percent, respectively, compared with 29.6 percent for placebo.

"Creating the capacity to make an accurate diagnosis of MDR tuberculosis and to treat the patients with this disease appropriately is a monumental task but one that cannot be avoided if tuberculosis is to be contained," write the authors of an accompanying editorial.

The Gler study was funded by Otsuka Pharmaceutical Development and Commercialization; several authors disclosed financial ties, including employment, to Otsuka.

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