Clinical Outcomes of vaccination campaigns in Patients with multidrug-resistant tuberculosis
DOI:
https://doi.org/10.5281/zenodo.22812074Keywords:
multidrug-resistant tuberculosis, BCG vaccination, tuberculosis vaccine, preventive therapy, treatment outcomesAbstract
Background: MDR-TB treatment remains long, toxic, and inconsistently successful, and vaccination has re-entered discussion as a complementary strategy to reduce progression to drug-resistant disease [2].
Objective: This review synthesizes evidence on BCG effectiveness, novel vaccine candidates, and MDR-TB-directed preventive therapy, and evaluates their clinical relevance to patients with, or at risk of, multidrug-resistant tuberculosis.
Methods: We narratively synthesized randomized trials, individual patient data meta-analyses, and systematic reviews identified through PubMed, the Cochrane Library, major trial registries, and World Health Organization reporting.
Findings: BCG reliably prevents disseminated childhood tuberculosis but shows inconsistent, waning protection against adult pulmonary disease [3,4,14]; M72/AS01E has shown efficacy against progression to active disease in infected adults [5,6]; and fluoroquinolone preventive therapy in MDR-TB household contacts robustly reduced incident disease [7,8,21], a benchmark set against gains from shorter all-oral regimens [25,26].
Conclusions: No trial has yet reported MDR-TB-specific outcomes for a vaccine, but new candidates, correlates-of-protection research, and proven preventive therapy in MDR-TB contacts outline a credible path toward MDR-TB-focused prevention.
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