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Abstract
Pyrazinamide (PZA) is an essential first-line tuberculosis drug for its unique mechanism of action active against multidrug-resistant-TB (MDR-TB). Thus, the aim of updated meta-analysis was to estimate the PZA weighted pooled resistance (WPR) rate in M. tuberculosis isolates based on publication date and WHO regions. We systematically searched the related reports in PubMed, Scopus, and Embase (from January 2015 to July 2022). Statistical analyses were performed using STATA software. The 115 final reports in the analysis investigated phenotypic PZA resistance data. The WPR of PZA was 57% (95% CI 48–65%) in MDR-TB cases. According to the WHO regions, the higher WPRs of PZA were reported in the Western Pacific (32%; 95% CI 18–46%), South East Asian region (37%; 95% CI 31–43%), and the Eastern Mediterranean (78%; 95% CI 54–95%) among any-TB patients, high risk of MDR-TB patients, and MDR-TB patients, respectively. A negligible increase in the rate of PZA resistance were showed in MDR-TB cases (55% to 58%). The rate of PZA resistance has been rising in recent years among MDR-TB cases, underlines the essential for both standard and novel drug regimens development.
Authors’ contribution statement
HH, RGH, FK, HK contributed to the conception, design, searching, data extraction, data curing, and drafting of the work. LM performed the statistical analysis. EK contributed in revising and final approval of the version to be published. All authors agreed and confirmed the manuscript for publication.
Disclosure statement
No potential conflict of interest was reported by the authors.
Ethical approval
The study protocol was approved by the Health Research Ethics Committee of the Golestan University of Medical Sciences (reference no. IR.GOUMS.REC.1400.233).