title: [Multidrug-resistant tuberculosis management in three French hospitals].
abstract: BACKGROUND
  Multidrug-resistant tuberculosis (MDR-TB) management is based on specific WHO guidelines.
  
  
  OBJECTIVE
  The authors report MDR-TB management, in three French hospitals.
  
  
  METHODS
  The authors retrospectively included patients with positive sample for multidrug-resistant Mycobacterium tuberculosis (isoniazid+rifampicin) from January 1, 2000 to December 31, 2005. The management was compared to the French and international prevalent guidelines.
  
  
  RESULTS
  Sixteen patients were initially managed for MDR-TB by eight different medical teams over 6 successive years: 12 (75%) presented with primary MDR-TB. Management advice from the national referee center (NRC) for tuberculosis was reported in seven out of 14 treated cases. The median length of the intensive treatment was 2 months (IQR: 1-3). Eight patients (58%) had an overall treatment length of 18 months. The median number of effective drugs prescribed was 4 (IQR: 4-5). Nine patients (64%) were also managed in a sanatorium. Only eight patients (57%) completed the prescribed treatment. Nine patients were clinically cured and still followed-up, six of whom were bacteriologically cured.
  
  
  CONCLUSIONS
  TB-MDR management was not conform to WHO guidelines in our study. Management in a sanatorium, NRC involvement, ambulatory DOT were highly beneficial.
authors.affiliation: Service des maladies infectieuses, hôpital Avicenne, 125 route de Stalingrad, Bobigny, France. segolene.greffe@free.fr
authors.forename: S
authors.initials: S
authors.lastname: Greffe
authors.forename: I
authors.initials: I
authors.lastname: Gros
authors.forename: P
authors.initials: P
authors.lastname: Cruaud
authors.forename: M
authors.initials: M
authors.lastname: Hornstein
authors.forename: O
authors.initials: O
authors.lastname: Fain
authors.forename: C
authors.initials: C
authors.lastname: Poirier
authors.forename: S
authors.initials: S
authors.lastname: Abgrall
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000208:ethnology; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001208:Asia / Q000208:ethnology; D019468:Disease Management; D004359:Drug Therapy, Combination; D005260:Female; D005602:France / Q000453:epidemiology; D006763:Hospitals, Chronic Disease / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents