title: Study of factors influencing response and outcome of Cat-IV regimen in MDRTB patients.
abstract: BACKGROUND
  CAT IV regimen or the standardized drug regimen (SDR) under the Revised National Control Program (RNTCP) uses six second-line anti-tubercular drugs in the initial intensive phase (IP). These drugs have many side effects and toxicity; they are less efficacious and have poor acceptability. The present study was conducted to evaluate the efficacy and outcome of Cat-IV regimen and the factors which influence the treatment outcome in MDR TB patients.
  
  
  METHODS
  It was a prospective observational study, which was done in the CAT II treatment failure, LPA proven MDR TB patients, above the age of 18 years, who were referred to DOTS Plus center for treatment. The study was approved by the hospital ethics committee and patient consent was obtained before inclusion.
  
  
  RESULTS
  We observed culture conversion in 63.04% and ADR in 96.5%, default in 15.65%, and death in11.3% cases. The factors which influenced outcome included low body weight, long duration of illness cavitatory disease and indulgence in both tobacco & alcohol. The radiological favorable response strongly and significantly correlated with the bacteriological and clinical response during the IP.
  
  
  CONCLUSIONS
  We suggest that the efficacy can be further augmented by reducing default and controlling deaths which accounts for substantial numbers and occur mostly during IP.
authors.affiliation: Associate Professor, Department of Respiratory Medicine, NIMS Medical College, Jaipur, Rajasthan, India.
authors.forename: Arun Kumar
authors.initials: AK
authors.lastname: Yadav
authors.affiliation: Associate Professor, Department of Respiratory Medicine, NIMS Medical College, Jaipur, Rajasthan, India. Electronic address: mehash49@yahoo.co.in.
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Mehrotra
authors.affiliation: Professor, Institute of Respiratory Medicine, SMS Medical College, Jaipur, Rajasthan.
authors.forename: S P
authors.initials: SP
authors.lastname: Agnihotri
authors.affiliation: Assistant Professor, Department of Respiratory Medicine, NIMS Medical College, Jaipur, Rajasthan.
authors.forename: Shivani
authors.initials: S
authors.lastname: Swami
mesh_terms: D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D011446:Prospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents
keywords: CAT IV regimen; MDR TB; RNTCP