Impact of fluoroquinolone resistance on the cost-effectiveness of empiric treatment for multidrug- or rifampicin-resistant tuberculosis.

ABSTRACT: The WHO recommends the bedaquiline, pretomanid, and linezolid (BPaL) regimen with the additional fluoroquinolone antibiotic moxifloxacin (BPaLM) for initial treatment of multidrug- or rifampicin-resistant tuberculosis (MDR/RR-TB). However, fluoroquinolone drug susceptibility testing (DST) coverage for MDR/RR-TB is only around 55% globally, and the efficacy of moxifloxacin may be compromised in settings with high fluoroquinolone resistance. We extended a previous Markov cohort model to assess the cost-effectiveness of the empirical use of BPaLM as a replacement for BPaL for the treatment of MDR/RR-TB in four high MDR/RR-TB burden countries. We obtained fluoroquinolone resistance rates in these countries from WHO surveillance data and parameterised treatment efficacy from recent trial result

SUBMITTER: Kim C 

PROVIDER: S-EPMC12530546 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature