PMID- 32154506 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231113 IS - 2589-5370 (Electronic) IS - 2589-5370 (Linking) VI - 20 DP - 2020 Mar TI - Injectable-free regimens containing bedaquiline, delamanid, or both for adolescents with rifampicin-resistant tuberculosis in Khayelitsha, South Africa. PG - 100290 LID - 10.1016/j.eclinm.2020.100290 [doi] LID - 100290 AB - BACKGROUND: Limited data exist on the use of bedaquiline and delamanid in adolescents with rifampicin-resistant tuberculosis (RR-TB). We describe RR-TB treatment of adolescents (10-19 years) with injectable-free regimens containing these drugs in Khayelitsha, South Africa. METHODS: This retrospective study included adolescents initiating injectable-free RR-TB treatment regimens containing bedaquiline and/or delamanid from February 2015 to June 2018. We report adverse events (AEs) of interest, sputum culture conversion (SCC), and final end-of-treatment outcomes. FINDINGS: Twenty-two patients were included; median age at treatment initiation was 17 years (interquartile range [IQR] 15-18), and six (27%) were HIV-positive (median CD4 count 191 cells/mm3 [IQR 157-204]). Eight (36%) patients had RR-TB with fluoroquinolone resistance; ten (45%), eight (36%), and four (18%) patients received regimens containing bedaquiline, delamanid, or the combination of bedaquiline and delamanid, respectively. The median durations of exposure to bedaquiline and delamanid were 5.6 (IQR 5.5-8.4) and 9.4 (IQR 5.9-14.4) months, respectively. There were 49 AEs of interest which occurred in 17 (77%) patients. Fourteen (64%) patients had pulmonary TB with positive sputum cultures at bedaquiline and/or delamanid initiation; among these SCC at month 6 was 79%. Final end-of-treatment outcomes for the 22 adolescent were: 17 (77%) successfully treated, two (9%) lost-to-follow-up, two (9%) treatment failed, and one (5%) died. INTERPRETATION: This study found that injectable-free regimens containing bedaquiline and/or delamanid in a programmatic setting were effective and well tolerated in adolescents and should be routinely provided for RR-TB treatment in this age group as recommended by the World Health Organisation. CI - (c) 2020 Published by Elsevier Ltd. FAU - Mohr-Holland, Erika AU - Mohr-Holland E AD - Medecins Sans Frontieres, Khayelitsha Project and Cape Town Mission, 2nd Floor Isivivana Centre, 1 Julius Tsolo Street, Khayelitsha, Cape Town 7784, South Africa. AD - Medecins Sans Frontieres, Southern Africa Medical Unit, 4th Floor Deneb House, 368 Main Rd, Observatory, Cape Town 7925, South Africa. FAU - Reuter, Anja AU - Reuter A AD - Medecins Sans Frontieres, Khayelitsha Project and Cape Town Mission, 2nd Floor Isivivana Centre, 1 Julius Tsolo Street, Khayelitsha, Cape Town 7784, South Africa. FAU - Furin, Jennifer AU - Furin J AD - Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Ave., Boston 02115, MA, United States. FAU - Garcia-Prats, Anthony AU - Garcia-Prats A AD - Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Desmond Tutu TB Centre, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa. FAU - De Azevedo, Virginia AU - De Azevedo V AD - City Health Department, Ntlazane Rd, Khayelitsha, Cape Town 7784, South Africa. FAU - Mudaly, Vanessa AU - Mudaly V AD - Provincial Department of Health- Western Cape, 1st floor Norton Rose House, 8 Riebeek Street Cape Town 8001, South Africa. FAU - Kock, Yulene AU - Kock Y AD - National Department of Health, Civitas Building, 222 Thabo Sehume St, CBD, Pretoria 0001, South Africa. FAU - Trivino-Duran, Laura AU - Trivino-Duran L AD - Medecins Sans Frontieres, Khayelitsha Project and Cape Town Mission, 2nd Floor Isivivana Centre, 1 Julius Tsolo Street, Khayelitsha, Cape Town 7784, South Africa. FAU - Isaakidis, Petros AU - Isaakidis P AD - Medecins Sans Frontieres, Southern Africa Medical Unit, 4th Floor Deneb House, 368 Main Rd, Observatory, Cape Town 7925, South Africa. FAU - Hughes, Jennifer AU - Hughes J AD - Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Desmond Tutu TB Centre, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa. LA - eng PT - Journal Article DEP - 20200303 PL - England TA - EClinicalMedicine JT - EClinicalMedicine JID - 101733727 PMC - PMC7057194 COIS- We declare no competing interests. EDAT- 2020/03/11 06:00 MHDA- 2020/03/11 06:01 PMCR- 2020/03/03 CRDT- 2020/03/11 06:00 PHST- 2019/08/08 00:00 [received] PHST- 2020/01/31 00:00 [revised] PHST- 2020/02/07 00:00 [accepted] PHST- 2020/03/11 06:00 [entrez] PHST- 2020/03/11 06:00 [pubmed] PHST- 2020/03/11 06:01 [medline] PHST- 2020/03/03 00:00 [pmc-release] AID - S2589-5370(20)30034-1 [pii] AID - 100290 [pii] AID - 10.1016/j.eclinm.2020.100290 [doi] PST - epublish SO - EClinicalMedicine. 2020 Mar 3;20:100290. doi: 10.1016/j.eclinm.2020.100290. eCollection 2020 Mar.