Is standardized treatment appropriate for non-XDR multiple drug resistant tuberculosis cases? A clinical descriptive study.
The clinical relevance of second-line drug susceptibility test (DST) results with respect to treatment outcome is unknown in non-XDR MDR patients. This study was carried out in the sole national referral centre for TB in Iran between 2002 and 2006. Multidrug-resistant tuberculosis (MDR-TB) patients who had DST to second-line drugs were included. For all MDR-TB patients the standard second-line regimen was initiated. Outcome of treatment based on DST to second-line drugs was analysed. 53 patients were included. DST for second-line drugs was available for 40 patients. Seven patients returned to Afghanistan during treatment. Among the remainder, 13 (30.4%) cases were Iranian. Mean age was 40.8 + 19.7 y. The relatively small sample size imposes some limitations on this study. However, in this study, there was no difference in resistance to second-line drugs by nationality. No significant correlation was seen between resistance to second-line drugs and outcome of treatment. In conclusion, the treatment outcome according to WHO definitions was appropriate in the study population by the use of standardized treatment regimens. Follow-up studies on a long-term basis are however needed in order to detect possible relapses.
Tabarsi
Payam
P
Mycobacteriology Research Centre, N.R.I.T.L.D, Shaheed Beheshti Medical University, Tehran, Iran. tabarsi@nritld.ac.ir
Baghaei
Parvaneh
P
Jalali
Sara
S
Farnia
Parisa
P
Chitsaz
Ehsan
E
Mirsaeidi
Mehdi
M
Kazempour
Mehdi
M
Mansouri
Davoud
D
Masjedi
Mohammad R
MR
Velayati
Ali A
AA
D000328:Adult; D000346:Afghanistan; D000583:Amikacin / Q000494:pharmacology / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D006801:Humans; D007492:Iran / Q000208:ethnology; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000208:ethnology / Q000382:microbiology; D055815:Young Adult
D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents; D000583:Amikacin