Results of a 12-month regimen for drug-resistant pulmonary tuberculosis.
METHODS
Several therapeutic regimens for drug-resistant tuberculosis have been suggested, most of them with a total duration of 18-24 months.


OBJECTIVE
To report our experience using a shorter regimen.


METHODS
Fifty patients with drug-resistant pulmonary tuberculosis were managed by withdrawing all anti-tuberculosis drugs until the results of a drug sensitivity test were obtained (approximately 3 months), and then a 12-month self-administered regimen with four to six anti-tuberculosis drugs at full daily doses was initiated, based primarily on the sensitivity test and secondarily on the history of previous treatment.


RESULTS
In 31 patients treatment was completed as planned, in six it was irregular and 13 definitively abandoned it. In the best scenario, 90.3% (28/31) of patients with full treatment were cured; this outcome was similar for both multidrug-resistant (MDR, n = 18, 88.9%) and non-MDR (n = 13, 92.3%) patients. Six months later, the relapse rate was 4.8%, and after a 5-year follow-up 14 out of 18 cured patients who were located remained asymptomatic (77.8%). If the worst scenario was applied, a 62.0% cure rate (31/50) was obtained.


CONCLUSIONS
A 12-month regimen with a minimum of four anti-tuberculosis agents at full dose, essentially selected on drug sensitivity testing, could be an alternative option for the treatment of drug-resistant pulmonary tuberculosis.
Pérez-Guzmán
C
C
Instituto Nacional de Enfermedades Respiratorias, Mexico DF, Mexico.
Vargas
M H
MH
Martínez-Rossier
L A
LA
Torres-Cruz
A
A
Villarreal-Velarde
H
H
D000293:Adolescent; D000328:Adult; D000904:Antibiotics, Antitubercular / Q000008:administration & dosage* / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004977:Ethambutol / Q000008:administration & dosage* / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011718:Pyrazinamide / Q000008:administration & dosage* / Q000627:therapeutic use*; D012293:Rifampin / Q000008:administration & dosage* / Q000627:therapeutic use*; D013307:Streptomycin / Q000008:administration & dosage* / Q000627:therapeutic use*; D013997:Time Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents; D011718:Pyrazinamide; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin; D013307:Streptomycin