Particularities of a cohort of preXDR / XDR TB patients treated with group 5 medication, hospitalized in MDR TB Department Institute of Pneumophtisiology Bucharest, Romania

PreXDR and XDRTB (second line injectables SLI+/-fluoroquinolone FQ added to HR resistance) is a crucial Romanian issue since TB group 5 medicines are accessible only through donor-funded programs. 35 patients were hospitalized in 6 months (July 2015–Feb 2016).Most were middle age males (68.5%, 45.7 ys), from rural area (75%). 34 patients had pulmonary TB-1 new case,4 relapses,29 failures to individualized treatment;1 had new extrapulmonary XDRTB (hepatic and splenic abscess). Previous period of treatment was 3.4 ys in average.All pts had a drug sensitivity test,registering preXDR SLI(5.7%),preXDR FQ(11.4%) and XDR (82.9%). 4 patients had previous surgical treatment (lobectomy, pneumonectomy).Comorbidities associated with decrease imunity were HIV, diabetes, neoplasia. Treatment regimen associated moxifloxacine(100%),SLI(capreomicine 88.5%,kanamicine 5.7%,amikacine 2.8%), second line TBdrugs (cycloserine 82.9%,prothionamide 65.7%,PAS 5.7%) and group 5 TB drugs (linezolid 97,1%,clofazimine 100%, imipenem+cilastatin 85.7%, amoxicilina+clavulanat 85.7%, bedaquiline 22.4%). We notified some adverse events such as digestive problems, liver cytolysis, peripheral neuropathy.No QTc prolongation was registered at bedaquiline treated group. If we considere only the contagious patients at hospital admission,78.2% became smear negative,after 2 months of treatment.At 3 months of treatment, 48,4% were culture negative. These first stage encouraging results may become evidence to support the stakeholders to insure availability of group 5 medicines as XDR TB is a Romanian recognized milestone public health problem.