The role of so-called xe2x80x9cgroup 5xe2x80x9d second-line drugs as a part of antibiotic therapy for multidrug-resistant tuberculosis (MDR-TB) is widely debated. We performed an individual patient data meta-analysis to evaluate the effectiveness of several group 5 drugs including amoxicillin/clavulanic acid; thioacetazone; the macrolide antibiotics; linezolid; clofazimine and terizidone for treatment of patients with MDR-TB.Detailed individual patient data were obtained from 31 published cohort studies of MDR-TB therapy. Pooled treatment outcomes for each group 5 drug were calculated using a random effects meta-analysis. Primary analyses compared treatment success to a combined outcome of failure; relapse or death.Among 9282 included patients; 2191 received at least one group 5 drug. We found no improvement in treatment success among patients taking clofazimine; amoxicillin/clavulanic acid or macrolide antibiotics; despite applying a number of statistical approaches to control confounding. Thioacetazone was associated with increased treatment success (OR 2.6; 95% CI 1.1xe2x80x936.1) when matched controls were selected from studies in which the group 5 drugs were not used at all; although this result was heavily influenced by a single study.The development of more effective antibiotics to treat drug-resistant TB remains an urgent priority.
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