Comprehensive Treatment of Extensively Drug-Resistant Tuberculosis

New England Journal of Medicine Volume 359:563-574 August 7, 2008 Number 6 This study shows that an aggressive, comprehensive management program can cure more than 60% of patients with extensively drug-resistant tuberculosis who are not infected with HIV but who have received numerous unsuccessful antituberculosis treatments. Culture conversion was delayed by nearly 1 month in the study patients who had extensively drug-resistant tuberculosis as compared with those who had multidrug-resistant tuberculosis, yet the frequency of cure or relapse and the risk of death did not differ significantly between the two groups of patients. The sample size afforded 80% power to detect differences in risk of more than two. The comparison population — patients with multidrug-resistant tuberculosis — had extensive resistance, prior treatment exposure, and parenchymal damage, which may explain the attenuated difference.