A fifteen-month survey of directly observed therapy--short course and antibiotic drug resistance in the region of Plovdiv.
OBJECTIVE
This study addresses the issue of antituberculosis drug resistance in a cohort of 213 patients from Plovdiv included in the pilot phase of a DOTS based project for a 15-month period. Between July 1. 1998 and September 30, 1999, ninety three culture-positive patients participated in the study. 89 of them were tested for drug susceptibility to rifampicin, izoniazid, etambutol, and streptomycin.


RESULTS
Resistance to at least one antituberculosis drug was established in 24.7% of the patients. Monoresistance was found in 13.5% of the cases. The median prevalence of combined resistance to rifampicin and isoniazid was 6.7%. The prevalence of resistance to rifampicin or isoniazid was 21.4%. Drug susceptibility testing results were obtained within 67 days. In 33% of the patients continuation treatment phase was initiated before drug susceptibility data were available.


CONCLUSIONS
During the observed period a considerably high rate of drug resistant tuberculosis was registered among the patients included in the pilot phase of the program based on Directly Observed Therapy--Short Course. The percentage of resistance to R and/or I gives better information about the risk of inadequate treatment during the continuation treatment phase. The high percentage of this pattern of resistance in our region requires the continued use of four first-line drugs for therapy until the results of drug-susceptibility testing are received.
Torosyan
A A
AA
Department of Internal Medicine, Clinics of Pulmonary Diseases, Higher Medical Institute, Plovdiv, Bulgaria.
Gurova
A A
AA
Mandulova
P V
PV
D000328:Adult; D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology; D000995:Antitubercular Agents / Q000008:administration & dosage*; D002031:Bulgaria / Q000453:epidemiology; D015331:Cohort Studies; D023801:Directly Observed Therapy; D004334:Drug Administration Schedule; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D018570:Risk Assessment; D017678:Sex Distribution; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D014505:Urban Population
D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents