Case Report: Therapeutic Threshold for Rifampicin-Resistant Tuberculosis in a Patient from Maputo, Mozambique.

Abstract

We present a case of a patient in Mozambique, who initiated treatment for rifampicin-resistant tuberculosis (RR-TB) without proof of resistance. For this patient, we estimated the probability of RR-TB using likelihood ratios of clinical arguments. The probability of RR-TB in Mozambique, positive HIV status, and treatment failure after a first treatment and after retreatment were included as confirming arguments, and a rapid molecular test showing rifampicin susceptibility as excluding argument. The therapeutic threshold to start treatment for RR-TB is unknown, but probably lower than 47% and should be calculated to guide clinical decisions.

• Authors: Lorena D M Gonzaga, Tinne Gils, Tom Decroo, Bart K M Jacobs, Lutgarde Lynen
• Journal: The American journal of tropical medicine and hygiene (Am J Trop Med Hyg) Vol. 104 Issue 4 Pg. 1317-1320 (02 08 2021) ISSN: 1476-1645 [Electronic] United States
• PMID: 33556043 (Publication Type: Case Reports)

Chemical References

• Antitubercular Agents
• Rifampin

Topics

• Adult
• Antitubercular Agents (pharmacology, therapeutic use)
• Female
• HIV Infections (complications)
• Humans
• Mozambique
• Mycobacterium tuberculosis (drug effects, genetics)
• Rifampin (pharmacology)
• Treatment Failure
• Tuberculosis, Multidrug-Resistant (diagnosis, drug therapy)