title: Retreatment of tuberculosis patients in the city of Porto Alegre, Brazil: outcomes.
abstract: OBJECTIVE
  To describe the outcomes of retreatment in tuberculosis patients receiving the regimen known, in Brazil, as regimen 3 (streptomycin, ethambutol, ethionamide, and pyrazinamide for 3 months + ethambutol and ethionamide for 9 months) after treatment failure with the basic regimen (rifampin, isoniazid, and pyrazinamide for 2 months + rifampin and isoniazid for 4 months).
  
  
  METHODS
  A descriptive, uncontrolled, historical cohort study involving adult tuberculosis patients treated with regimen 3. We evaluated adverse drug effects, recurrence, treatment outcomes, and associated factors.
  
  
  RESULTS
  The study included 229 patients. The overall cure rate was 62%. For the patients who used the medications regularly and those who did not, the cure rate was 88% and 31%, respectively. Adverse events occurred in 95 patients (41.5%), and most of those events were related to the gastrointestinal tract. In the five-year follow-up period, relapse occurred in 17 cases (12.0%).
  
  
  CONCLUSIONS
  Overall, the outcomes of treatment with regimen 3 were unsatisfactory, in part because this regimen was administered to a selected population of patients at high risk for noncompliance with treatment, as well as because it presents high rates of adverse effects, especially those related to the gastrointestinal tract, which might be caused by ethionamide. However, for those who took the medications regularly, the cure rate was satisfactory. The recurrence rate was higher than that recommended in international consensus guidelines, which might be attributable to the short (12-month) treatment period. We believe that regimen 3, extended to 18 months, represents an option for patients with proven treatment compliance.
authors: Hospital Sanatório Partenon, Rio Grande do Sul State Health Department, Porto Alegre, Brazil. pedro.picon@hotmail.com
authors: Pedro Dornelles
authors: PD
authors: Picon
authors: Carlos Fernando Carvalho
authors: CF
authors: Rizzon
authors: Sergio Luiz
authors: SL
authors: Bassanesi
authors: Luiz Carlos Correa da
authors: LC
authors: Silva
authors: Maria de Lourdes
authors: Mde L
authors: Della Giustina
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D001938:Brazil; D015331:Cohort Studies; D004359:Drug Therapy, Combination / Q000379:methods; D004977:Ethambutol / Q000008:administration & dosage / Q000009:adverse effects; D005000:Ethionamide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D011718:Pyrazinamide / Q000008:administration & dosage / Q000009:adverse effects; D019233:Retreatment / Q000379:methods; D013307:Streptomycin / Q000008:administration & dosage / Q000009:adverse effects; D017211:Treatment Failure; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents; D011718:Pyrazinamide; D004977:Ethambutol; D005000:Ethionamide; D013307:Streptomycin