title: [Outcome and treatment among patients with multidrug-resistant tuberculosis].
abstract: OBJECTIVE
  Although progress has been made to reduce the global incidence of tuberculosis, the emergence of multidrug-resistant tuberculosis during the past decade threatens to limit these results. The aim of this study is to evaluate the geographic distribution, clinical and microbiological characteristics and outcomes of multidrug-resistant tuberculosis patients in Spain.
  
  
  METHODS
  Retrospective study between January 1998 and December 2010 of patients attended in Cantoblanco-La Paz Hospital Isolation Internal Medicine Unit.
  
  
  RESULTS
  Forty-seven patients were studied, with a mean age of 36 years. There were 33 male. Sixty-four per cent were immigrants and the mean residence time in Spain was 12 months. Twenty-six patients (55.3%) were new cases. Patients were resistant to a median of 5 drugs (interquartile range [IQR] 3-7) and 3 patients had extensively drug-resistant tuberculosis. Cultures became negative after a median of 68.5 days (IQR 49.5-91.8). The median length of hospitalization was 2.75 months (IQR 1.3-4.6). They were treated during a median of 22.4 months (IQR 15.3-24.3). The overall success rate was 93%. A directly observed treatment was carried out in 79% of patients. Sixty-eight per cent patients presented side effects. In 75% of the cases the effects were mild and moderate with no need to replace the drug. Fourteen patients were followed up for a median of 40.5 months (IQR 7.4-55) and no clinical or bacteriological manifestation of disease was detected.
  
  
  CONCLUSIONS
  Most patients with multidrug-resistant tuberculosis can be cured with the use of appropriate and intensive regimens, management of side effects and implementation of strategies to improve adherence to treatment.
authors.affiliation: IdiPAZ, Servicio de Medicina Interna, Unidad de Aislamiento, Hospital Universitario de Cantoblanco-La Paz, Madrid, España. mrlapausa@yahoo.com
authors.forename: Marta
authors.initials: M
authors.lastname: Ramírez Lapausa
authors.forename: José Francisco
authors.initials: JF
authors.lastname: Pascual Pareja
authors.forename: Mariam
authors.initials: M
authors.lastname: Amer López
authors.forename: Mariam
authors.initials: M
authors.lastname: Amer Pérez
authors.forename: José Luis
authors.initials: JL
authors.lastname: Vidal Pérez
authors.forename: Arturo
authors.initials: A
authors.lastname: Noguerado Asensio
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023801:Directly Observed Therapy / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy / Q000453:epidemiology / Q000208:ethnology / Q000382:microbiology; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents