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Stewardship / Resistance Scan for Aug 11, 2022

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Study: Treatment for drug-resistant TB limited, costly in EuropeA survey of tuberculosis (TB) treatment centers in Europe found the availability of drug susceptibility testing (DST) for new and repurposed TB drugs in Europe is severely limited, drugs and regimens for drug-resistant TB are limited, and treatment costs for drug-resistant TB are very high, according to a study published this week in Clinical Microbiology and Infection.For the study, a team of researchers with the Tuberculosis Network European Trials group (TBNET) surveyed 43 TB treatment centers in 40 countries in the World Health Organization (WHO) European region, gathering data on DST, TB drug availability, and cost.

They focused on treatment regimens for drug-susceptible TB (DS-TB), multidrug-resistant/rifampicin-resistant TB (MDR/RR-TB), extensively drug-resistant TB (XDR-TB), and pre-XDR-TB.For WHO Group A drugs (levofloxacin/moxifloxacin, bedaquiline, and linezolid) the frequency of countries with availability of phenotypic DST was as follows: 30/40 (75%) for levofloxacin, 33/40 (82%) for moxifloxacin, 19/40 (48%) for bedaquiline and 29/40 (72%) for linezolid.

Overall, 36/43 (84%) and 24/43 (56%) of countries had access to bedaquiline and delamanid, which while only 6/43 (14%) had access to rifapentine.

Treatment of patients with XDR-TB with a regimen including a carbapenem was available in only 17/43 (40%) of the countries.The median cost of regimens for DS-TB, MDR/RR-TB (shorter regimen, including bedaquiline for 6 months), and XDR-TB (including bedaquiline, delamanid, and a carbapenem) were €44 ($45.50 US), €764 ($789 US), and €8,709 ($9,004 US), respectively, in middle-income countries, and €280 ($289 US), €29,765 ($30,733 US), and €217,591

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