Predictors of two months culture conversion in multidrug-resistant tuberculosis: findings from a retrospective cohort study.
BACKGROUND
Various studies have reported culture conversion at two months as a predictor of successful treatment outcome in multidrug-resistant tuberculosis (MDR-TB).


OBJECTIVE
The present study was conducted with the aim to evaluate the rate and predictors of culture conversion at two months in MDR-TB patients.


METHODS
All confirmed pulmonary MDR-TB patients enrolled for treatment at Lady Reading Hospital Peshawar, Pakistan from 1 January to 31 December 2012 and met the inclusion criteria were reviewed retrospectively. Rate and predictors of culture conversion at two months were evaluated.


RESULTS
Eighty seven (53.4%) out of 163 patients achieved culture conversion at two months. In a multivariate analysis lung cavitation at baseline chest X-ray (P = 0.006, OR = 0.349), resistance to ofloxacin (P = 0.041, OR = 0.193) and streptomycin (P = 0.017, OR = 0.295) had statistically significant (P<0.05) negative association with culture conversion at two months.


CONCLUSIONS
A reasonable proportion of patients achieved culture conversion at two months. Factors negatively associated with culture conversion at two months can be easily identified either before diagnosis or early in the course of MDR-TB treatment. This may help in better care of individual patients by identifying them early and treating them vigorously.
Post Graduate Medical Institute, Peshawar, Pakistan.
Anila
A
Basit
Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia.
Nafees
N
Ahmad
Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia.
Amer Hayat
AH
Khan
Department of Pulmonology, Lady Reading Hospital, Peshawar, Pakistan.
Arshad
A
Javaid
Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia.
Syed Azhar
SA
Syed Sulaiman
Programmatic Management Unit of Drug Resistant TB, Lady Reading Hospital, Peshawar, Pakistan.
Afsar Khan
AK
Afridi
Chronic Kidney Disease (CKD) Resource Center, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
Azreen Syazril
AS
Adnan
Department of Pediatrics, Saidu Medical College, Saidu Sharif Swat, Pakistan.
Israr ul
Iu
Haq
Khyber Medical University, Peshawar, Pakistan.
Syed Saleem
SS
Shah
Department of Pharmacy, University of Balochistan, Quetta, Pakistan.
Ahmed
A
Ahadi
Department of Microbiology, Quaid-e- Azam University, Islamabad, Pakistan.
Izaz
I
Ahmad
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000254:growth & development; D015242:Ofloxacin / Q000627:therapeutic use; D010154:Pakistan / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D013307:Streptomycin / Q000627:therapeutic use; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology
D000995:Antitubercular Agents; D015242:Ofloxacin; D013307:Streptomycin