Images in Paediatrics
Adolescence, multidrug resistant tuberculosis, bedaquiline and videotapes
Adolescencia, tuberculosis multirresistente, bedaquilina y cintas de vídeo
Anna Gamella,
, Cristina Latreb, Maria Goretti López-Ramosb, Antoni Noguera-Juliana,c,d,e
Corresponding author
a Servicio de enfermedades infecciosas y patología importada, Hoapital Sant Joan de Déu, Barcelona, Spain
b Servicio de Farmacia, Hospital Sant Joan de Déu, Barcelona, Spain
c Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
d Departamento de Pediatría, Facultad de Medicina, Universitat de Barcelona, Barcelona, Spain
e Red de Investigación Traslacional en Infectología Pediátrica (RITIP), Madrid, Spain
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The World Health Organization (WHO) and different scientific societies favour oral treatment regimens with bedaquiline over second-line regimens containing injectable drugs, and recommend directly observed treatment (DOT).<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Although it has been considered the first-line drug for MDR-TB since 2019,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> bedaquiline was not funded in the Spanish health system until October 20, 2022.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We present the case of a female patient aged 15 years given a diagnosis of pulmonary MDR-TB in December 2020. We designed an all-oral treatment regimen with bedaquiline, levofloxacin, linezolid and clofazimine. We applied for funding for bedaquiline unsuccessfully, and our hospital eventually agreed to cover the drug costs (23 213). The patient completed 52 weeks of treatment, which achieved clinical and radiological resolution.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The patient was offered DOT, but refused it because it was incompatible with school hours. We offered overseeing her treatment through video-DOT. Every day, she recorded herself taking the drugs and sent the video through an app to her physicians. The experience was good, and we consider video-DOT a good option for adolescent TB patients in our setting.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Finally, we celebrate that bedaquiline is now funded in the Spanish public health system, both for the optimal treatment of individual patients and for the prevention of transmission in the community.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0040" class="elsevierStylePara elsevierViewall">The following is Supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0010" ] ] ] ] "multimedia" => array:1 [ 0 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 2022695 "Video" => array:2 [ "mp4" => array:5 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Ministerio de Sanidad - Profesionales - Salud Pública - Prevención y Promoción - Plan Tuberculosis [Internet]. [cited 2022 April 12]. Available from: <a target="_blank" href="https://www.sanidad.gob.es/profesionales/saludPublica/prevPromocion/PlanTuberculosis/planTuberculosis.htm">https://www.sanidad.gob.es/profesionales/saludPublica/prevPromocion/PlanTuberculosis/planTuberculosis.htm</a>." ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Update of SEPAR guideline «Diagnosis and Treatment of Drug-Resistant Tuberculosis»" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.A. Caminero" 1 => "J.M. García-García" 2 => "J.A. Caylà" 3 => "F.J. García-Pérez" 4 => "J.J. Palacios" 5 => "J. Ruiz-Manzano" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2020" "volumen" => "56" "paginaInicial" => "514" "paginaFinal" => "521" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Agencia Española de Medicamentos y Productos Sanitarios. Informe de Posicionamiento Terapéutico de Bedaquilina (Sirturo®) [Internet]. 2022 [Accessed 14 February 2023]. Available from: <a target="_blank" href="https://www.aemps.gob.es/medicamentosUsoHumano/informesPublicos/docs/IPT-bedaquilina-Sirturo-tuberculosis-pulmonar.pdf">https://www.aemps.gob.es/medicamentosUsoHumano/informesPublicos/docs/IPT-bedaquilina-Sirturo-tuberculosis-pulmonar.pdf</a>." ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack734035" "titulo" => "Acknowledgements" "texto" => "<p id="par0030" class="elsevierStylePara elsevierViewall">We thank Dr Julià Gonzalez-Martin for his contribution through the performance of drug susceptibility testing and its interpretation and Dr José A Caminero and for his valuable recommendations for the optimal management of our patient.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000009900000002/v2_202403140552/S2341287923001424/v2_202403140552/en/main.assets" "Apartado" => array:4 [ "identificador" => "77701" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Paediatrics" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000009900000002/v2_202403140552/S2341287923001424/v2_202403140552/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287923001424?idApp=UINPBA00005H" ]
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