title: Use of drug-susceptibility testing for management of drug-resistant tuberculosis, Thailand, 2004-2008.
abstract: In 2004, routine use of culture and drug-susceptibility testing (DST) was implemented for persons in 5 Thailand provinces with a diagnosis of tuberculosis (TB). To determine if DST results were being used to guide treatment, we conducted a retrospective chart review for patients with rifampin-resistant or multidrug-resistant (MDR) TB during 2004-2008. A total of 208 patients were identified. Median time from clinical sample collection to physician review of DST results was 114 days. Only 5.8% of patients with MDR TB were empirically prescribed an appropriate regimen; an additional 31.3% received an appropriate regimen after DST results were reviewed. Most patients with rifampin -resistant or MDR TB had successful treatment outcomes. Patients with HIV co-infection and patients who were unmarried or had received category II treatment before DST results were reviewed had less successful outcomes. Overall, review of available DST results was delayed, and results were rarely used to improve treatment.
authors.forename: Eugene
authors.initials: E
authors.lastname: Lam
authors.forename: Sriprapa
authors.initials: S
authors.lastname: Nateniyom
authors.forename: Sara
authors.initials: S
authors.lastname: Whitehead
authors.forename: Amornrat
authors.initials: A
authors.lastname: Anuwatnonthakate
authors.forename: Patama
authors.initials: P
authors.lastname: Monkongdee
authors.forename: Apiratee
authors.initials: A
authors.lastname: Kanphukiew
authors.forename: Jiraphan
authors.initials: J
authors.lastname: Inyaphong
authors.forename: Wanlaya
authors.initials: W
authors.lastname: Sitti
authors.forename: Navarat
authors.initials: N
authors.lastname: Chiengsorn
authors.forename: Saiyud
authors.initials: S
authors.lastname: Moolphate
authors.forename: Suporn
authors.initials: S
authors.lastname: Kavinum
authors.forename: Narin
authors.initials: N
authors.lastname: Suriyon
authors.forename: Pranom
authors.initials: P
authors.lastname: Limsomboon
authors.forename: Junya
authors.initials: J
authors.lastname: Danyutapolchai
authors.forename: Chalinthorn
authors.initials: C
authors.lastname: Sinthuwattanawibool
authors.forename: Laura Jean
authors.initials: LJ
authors.lastname: Podewils
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D062486:Public Health Surveillance; D019233:Retreatment; D012307:Risk Factors; D013785:Thailand; D017211:Treatment Failure; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents
keywords: MDR TB; TB; Thailand; anti-tuberculosis treatment; bacteria; clinical management; drug resistance; drug susceptibility testing; laboratory testing; multidrug-resistant tuberculosis; rifampin-resistant tuberculosis; treatment management; tuberculosis; tuberculosis and other mycobacteria