{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T16:37:00Z","timestamp":1775752620662,"version":"3.50.1"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T00:00:00Z","timestamp":1533081600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"European Commission\u2019s Seventh Framework Program","award":["FP7-223681"],"award-info":[{"award-number":["FP7-223681"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Multidrug-resistant tuberculosis (MDR-TB) is a major burden to public health in Europe. Reported treatment success rates are around 50% or less, and cure rates are even lower.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To document the management and treatment outcome in patients with MDR-TB in Europe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a prospective cohort study, analyzing management and treatment outcomes stratified by incidence of patients with MDR-TB in Europe. Treatment outcomes were compared by World Health Organization and alternative simplified definitions by the Tuberculosis Network European Trialsgroup (TBNET).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>A total of 380 patients with MDR-TB were recruited and followed up between 2010 and 2014 in 16 European countries. Patients in high-incidence countries compared with low-incidence countries were treated more frequently with standardized regimen (83.2% vs. 9.9%), had delayed treatment initiation (median, 111 vs. 28 d), developed more additional drug resistance (23% vs. 5.8%), and had increased mortality (9.4% vs. 1.9%). Only 20.1% of patients using pyrazinamide had proven susceptibility to the drug. Applying World Health Organization outcome definitions, frequency of cure (38.7% vs. 9.7%) was higher in high-incidence countries. Simplified outcome definitions that include 1 year of follow-up after the end of treatment showed similar frequency of relapse-free cure in low- (58.3%), intermediate- (55.8%), and high-incidence (57.1%) countries, but highest frequency of failure in high-incidence countries (24.1% vs. 14.6%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Conventional standard MDR-TB treatment regimens resulted in a higher frequency of failure compared with individualized treatments. Overall, cure from MDR-TB is substantially more frequent than previously anticipated, and poorly reflected by World Health Organization outcome definitions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201710-2141oc","type":"journal-article","created":{"date-parts":[[2018,3,6]],"date-time":"2018-03-06T15:46:12Z","timestamp":1520351172000},"page":"379-386","source":"Crossref","is-referenced-by-count":31,"title":["Clinical Management of Multidrug-Resistant Tuberculosis in 16 European Countries"],"prefix":"10.1093","volume":"198","author":[{"given":"Gunar","family":"G\u00fcnther","sequence":"first","affiliation":[{"name":"Research Center Borstel, Clinical Infectious Diseases, German Center for Infection Research, Borstel, Germany"},{"name":"Department of Medicine, University of Namibia School of Medicine, Windhoek, Namibia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5490-8968","authenticated-orcid":false,"given":"Frank","family":"van 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Public Health, Porto University, Porto, Portugal"},{"name":"Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal"}]},{"given":"Gina","family":"Gualano","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases \u201cL, Spallanzani,\u201d Rome, Italy"}]},{"given":"Heinke","family":"Kunst","sequence":"additional","affiliation":[{"name":"Queen Mary University, London, United Kingdom"}]},{"given":"Wiel","family":"de Lange","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen, Tuberculosis Centre Beatrixoord, Haren, the Netherlands"}]},{"given":"Vaira","family":"Leimane","sequence":"additional","affiliation":[{"name":"Riga East University Hospital, Tuberculosis and Lung Diseases Centre, Riga, Latvia"}]},{"given":"Anne-Marie","family":"McLaughlin","sequence":"additional","affiliation":[{"name":"St. James\u2019s Hospital, Dublin, Ireland"}]},{"given":"Cecile","family":"Magis-Escurra","sequence":"additional","affiliation":[{"name":"Radboud University Medical Centre\u2013TB Expert Centre UCCZ Dekkerswald, Nijmegen-Groesbeek, the Netherlands"}]},{"given":"Inge","family":"Muylle","sequence":"additional","affiliation":[{"name":"University Medical Center St. Pieter, Brussels, Belgium"}]},{"given":"Veronika","family":"Polcov\u00e1","sequence":"additional","affiliation":[{"name":"Thomayer University Hospital, Prague, Czech Republic"}]},{"given":"Cristina","family":"Popa","sequence":"additional","affiliation":[{"name":"Marius-Nasta-Institut, Bucharest, Romania"}]},{"given":"Rudolf","family":"Rumetshofer","sequence":"additional","affiliation":[{"name":"Otto Wagner Hospital, Vienna, Austria"}]},{"given":"Alena","family":"Skrahina","sequence":"additional","affiliation":[{"name":"Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, 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