In vitro drug resistance and response to therapy in pulmonary tuberculosis patients under a DOTS programme in south India.
Tuberculosis (TB) patients (n=605) whose pre-treatment sputum culture yielded Mycobacterium tuberculosis were studied for the association of in vitro resistance to anti-TB drugs and treatment outcome. Five hundred and fifty-four (92%) patients showed favourable outcome, while 51 (8%) showed unfavourable outcome to anti-TB treatment. Logistic regression analysis of the data revealed that male gender (Wald P=0.026) and multidrug resistance (MDR) (Wald P<0.001) were associated with unfavourable outcome. Proportion of treatment failure (6%) was higher in patients who had received earlier anti-TB drug therapy (re-treated patients) compared with the newly diagnosed patients (2%). Re-treated patients yielded more drug-resistant M. tuberculosis, including MDR (P<0.001), than new cases. Treatment guided by in vitro drug susceptibility tests may therefore be more effective and less expensive for such selected cases.
Aparna
S B
SB
LEPRA Blue Peter Research Center, Cherlapally, Hyderabad, Andhra Pradesh, India. Aparna@leprahealthinaction.in
Reddy
V C Kishore
VC
Gokhale
S
S
Moorthy
K V Krishna
KV
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000191:economics / Q000627:therapeutic use*; D002648:Child; D023801:Directly Observed Therapy / Q000191:economics; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D013183:Sputum / Q000382:microbiology*; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000191:economics / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000191:economics / Q000382:microbiology*; D055815:Young Adult
D000995:Antitubercular Agents