title: Study of Drug Resistant Pulmonary Tuberculosis.
abstract: BACKGROUND
  Drug resistance has emerged as a major problem in management of pulmonary tuberculosis (PT) with increase in its incidence.
  
  
  METHODS
  Sixty patients who presented to a tertiary referral chest centre with drug resistant PT were included in the study out of 835 clinically diagnosed cases of PT treated between January 2000 and May 2002. They were studied to see the incidence, pattern of drug resistance and response to treatment.
  
  
  RESULTS
  7.2% of the clinically diagnosed cases of PT had drug resistance and 14.8% of the 403 strains of mycobacterium tuberculosis (MTB) tested were resistant to one or more antitubercular drugs (ATD). 40 cases (66.7%) had initial resistance and acquired resistance was seen in 20(33.3%) out of the 60 cases of drug resistant PT. Single drug resistance was observed in 21 cases (35%), two drug resistance in 19 (31.7%) and 20(33.3%) cases showed resistance to three or more drugs. Individual drug resistance breakup was: INH(H) - 36(8.9%), Rifampicin (R)-38(9.4%), Ethambutol (E) - 14(3.5%), Streptomycin (S) - 34(8.4%), Pyrazinamide (Z) - 2(0.5%), Ciprofloxacin (C) - 2(0.5%), Ethionamide (N) - 2(0.5%), Cycloserine - 1(0.3%) and Kanamycin - 1(0.3%). 98.3% showed sputum conversion after starting reserve drugs. Average period of sputum conversion was 10 weeks. 3.3% were HIV positive.
  
  
  CONCLUSIONS
  Incidence of drug resistance was not as high as reported by some other workers and majority of the cases showed satisfactory outcome.
authors.affiliation: Classified Specialist (Medicine and Respiratory Medicine), Military Hospital, Cardio Thoracic Centre, Pune-40.
authors.forename: R B
authors.initials: RB
authors.lastname: Deoskar
authors.affiliation: Ex-PG Resident (Respiratory Medicine), Military Hospital, Cardio Thoracic Centre, Pune-40.
authors.forename: B
authors.initials: B
authors.lastname: Sengupta
authors.affiliation: Senior Adviser (Medicine and Respiratory Medicine), Military Hospital, Cardio Thoracic Centre, Pune-40.
authors.forename: K E
authors.initials: KE
authors.lastname: Rajan
authors.affiliation: Classified Specialist (Medicine and Respiratory Medicine), Military Hospital, Cardio Thoracic Centre, Pune-40.
authors.forename: M S
authors.initials: MS
authors.lastname: Barthwal
authors.affiliation: Commanding Officer, 4033 Field Ambulance, C/o 56 APO.
authors.forename: Jjj
authors.initials: J
authors.lastname: Falleiro
authors.affiliation: Deputy Director General, Armed Forces Medical Services (P), Office of the DGAFMS, Ministry of Defence, New Delhi.
authors.forename: S K
authors.initials: SK
authors.lastname: Sharma
keywords: Drug resistant pulmonary tuberculosis