Clinical efficacy and computed tomography diagnostic value of bedaquiline-containing regimens in the treatment of drug-resistant pulmonary tuberculosis

Objective

This study investigated the clinical efficacy of bedaquiline-containing regimens in the treatment of drug-resistant pulmonary tuberculosis and the diagnostic value of computed tomography (CT).

Methods

We retrospectively analyzed the clinical diagnosis, treatment, and CT imaging data of patients with drug-resistant pulmonary tuberculosis treated in Wenzhou Central Hospital from 1 January to 31 December 2022. According to whether the treatment regimen contained bedaquiline, the patients were divided into an observation group (bedaquiline tablets + background regimen) and a control group (background regimen). The clinical efficacy and pulmonary CT changes before and after treatment were analyzed in both groups.

Results

After 24 weeks of treatment, there was no statistically significant difference in the white blood cell count or concentrations of hemoglobin, alanine aminotransferase, serum albumin, or creatinine between the two groups (t = 0.71, 0.93, 0.05, 0.18, and 0.08, respectively; p > 0.05). After 4, 8, and 12 weeks of treatment, there was no statistically significant difference in the sputum culture-negative conversion rate between the two groups (χ² = 2.67, 0.48, and 1.82, respectively; p > 0.05). At 24 weeks of treatment, the sputum culture-negative conversion rate in the observation group reached 100%, which was significantly higher than that in the control group (χ² = 3.97, p < 0.05). The effective absorption rates on chest imaging in the two groups of patients at 12 weeks were 83.33% and 57.89%, respectively. At 24 weeks of treatment, the effective absorption rates were 88.00% and 65.85% in the two groups, with a statistically significant difference (χ² = 3.98; p < 0.05). There were significant differences in cavity absorption at 24 weeks (χ² = 4.33, p < 0.05) and 48 weeks after treatment (χ² = 10.63, p < 0.05).

Conclusion

The addition of bedaquiline to the background regimen improved the sputum culture-negative conversion rate and chest imaging effective rate. Patients achieved good results at the end of the 24-week treatment period.