Journal Article

Adjunctive Salvage Therapy with Inhaled Aminoglycosides for Patients with Persistent Smear-Positive Pulmonary Tuberculosis

Leonard V. Sacks, Stella Pendle, Dragana Orlovic, Marie Andre, Miriana Popara, Gavin Moore, Leif Thonell and Solly Hurwitz

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 1, pages 44-49
Published in print January 2001 | ISSN: 1058-4838
Published online January 2001 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/317524
Adjunctive Salvage Therapy with Inhaled Aminoglycosides for Patients with Persistent Smear-Positive Pulmonary Tuberculosis

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A proportion of patients with drug-resistant and drug-susceptible tuberculosis (TB) have sputum that is smear and culture positive for Mycobacterium tuberculosis for a prolonged period of time, despite conventional therapy. Among such patients with refractory TB, an unblinded, observational study was undertaken that used conventional TB therapy and adjunctive aerosol aminoglycosides. Patients with persistent smear- and culture-positive sputum for M. tuberculosis (despite ⩾2 months of optimal systemic therapy) were selected for adjunctive treatment via inhalation with aminoglycosides, and microbiological responses were monitored. Thirteen of 19 patients converted to smear negativity during the study: 6 of 7 with drug-susceptible TB and 7 of 12 with drug-resistant TB. Among patients with drug-susceptible TB, the median time to sputum conversion was 23 days, a shorter time than for a population of historical control patients. Recurrent infection was not observed. Adjunctive aerosol aminoglycosides may expedite sterilization of sputum among certain patients with refractory TB and diminish the risk of transmission.

Journal Article.  3998 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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