Using linezolid and bedaquiline in patients operated for multidrug-resistant pulmonary tuberculosis

Objective: to evaluate comprehensive treatment outcomes in patients operated for multidrug-resistant pulmonary tuberculosis (MDR-TB) with the inclusion of linezolid and bedaquiline in the chemotherapy (CTX) regimens. Materials and methods. We performed a non-randomized continuous single-center retrospective study on 114 patients operated on at the National Medical Research Center for Phthisiology of the Russian Federation Ministry of Healthcare from 2018 to 2022. We conducted a comparative analysis of the effectiveness of CTX regimens in patients with localized and extensive forms. Results. We detected a statistically significantly wider spectrum of Mycobacterium tuberculosis (MTB) drug resistance (DR) in 41.6% (n=32/77) of patients with tuberculomas and in 18.9% (n=7/37) of patients with fibrous cavernous tuberculosis based on the study of resection specimens vs. respiratory specimens (p=0.03). Inclusion of linezolid and bedaquiline in the CTX regimen for patients with MDR-TB resulted in a reduction in the duration of postoperative treatment by, on average, 14.0±1.3 weeks and 11.1±4.5 weeks, respectively, for localized TB forms and by 14.8±3.2 weeks and 14.9±3.7 weeks, correspondingly, for extensive TB forms vs. CTX regimens without these drugs. Conclusion. Addition of new antitubercular drugs (linezolid and bedaquiline) to the CTX regimen in patients with MDR-TB can reduce the treatment duration in case of both localized and extensive forms of the disease.