title: Outcomes among tuberculosis patients with isoniazid resistance in Georgia, 2007-2009.
abstract: BACKGROUND
  The optimal management strategy for patients with isoniazid (INH) monoresistant forms of tuberculosis (TB) has been widely debated. The current daily 9-month regimen of rifampin, pyrazinamide and ethambutol was established based largely on trials in settings with low TB  rates and low rates of drug resistance.
  
  
  OBJECTIVE
  To explore the outcomes of patients with INH-monoresistant TB in the country of Georgia, a setting with both high TB rates and drug-resistant forms of the disease.
  
  
  METHODS
  Retrospective record review of all patients diagnosed with smear-positive  pulmonary TB resistant to either INH or INH+SM (streptomycin) in Georgia between 2007 and 2009.
  
  
  RESULTS
  Of 8752 patients with pulmonary TB registered in Georgia, 909 were found to have INH or INH+SM resistance. Treatment outcomes were relatively poor in this group, with only 71% treatment  success. Outcomes were significantly worse among patients with older age and a history of previous treatment.
  
  
  CONCLUSIONS
  INH or INH+SM resistance in pulmonary TB patients in Georgia is common. The low rates of treatment success suggest the need for an improved treatment regimen for patients  with resistance to these first-line drugs; this need is particularly pronounced among the subset of patients with a history of previous treatment.
authors.affiliation: The National Center for TB and Lung Diseases, Georgia, Tbilisi, Georgia.
authors.forename: M
authors.initials: M
authors.lastname: Gegia
authors.forename: T
authors.initials: T
authors.lastname: Cohen
authors.forename: I
authors.initials: I
authors.lastname: Kalandadze
authors.forename: L
authors.initials: L
authors.lastname: Vashakidze
authors.forename: J
authors.initials: J
authors.lastname: Furin
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000627:therapeutic use*; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015999:Multivariate Analysis; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification; D011237:Predictive Value of Tests; D011718:Pyrazinamide / Q000627:therapeutic use*; D012189:Retrospective Studies; D012293:Rifampin / Q000627:therapeutic use*; D018570:Risk Assessment; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology; D013997:Time Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents; D011718:Pyrazinamide; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin