[Results of therapy in pulmonary tuberculosis: outcome monitoring in northern Lower Saxony].
BACKGROUND
Despite it importance standardized treatment outcome-monitoring in tuberculosis patients is not officially done in Germany.


METHODS
In this retrospective study we investigated tuberculosis outcome in 494 patients with pulmonary tuberculosis using the international recommended definitions.


RESULTS
The median follow-up period was 62 month (36-180 month). A successful treatment could be observed in 378 (76.1%) of all patients. Treatment success was mostly documented as cure (n = 375). No documented treatment success was seen in 119 patients (23.9%). The most important reason for unsuccessful treatment was lost for follow up (transfer out) in 60/119 patients (51.2%), followed by death (24/119; 19.8%), an interrupted treatment (22/199; 18.3%) and treatment failure (13/119; 10.7%). No documented treatment success was significantly more common in retreatment cases compared to new cases (p = 0.0003) and in patients with at least a single drug resistance (p = 0.04). Beside these parameters treatment outcome was significantly superior in patients receiving a standard antituberculosis therapy including at least isoniazid and rifampin compared to patients treated with other regimens during both the initial phase (p = 0.0039) and the continuous phase (p = 0.0021) of therapy.


CONCLUSIONS
In this retrospective study the use of the international definitions for outcome monitoring showed a substantial proportion of patients with unsuccessful therapy. For the evaluation of the success of the tuberculosis programme in Germany a prospective documentation of treatment outcome data in all patients using the international definitions seems essential.
Menke
B
B
Pneumologisches Zentrum Unterstedt, Diakoniekrankenhaus Rotenburg/Wümme.
Sommerwerck
D
D
Schaberg
T
T
D000368:Aged; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000401:mortality
D000995:Antitubercular Agents