ЭФФЕКТИВНОСТЬ ПРИМЕНЕНИЯ УКОРОЧЕННЫХ ЧЕТЫРЕХКОМПОНЕНТНЫХ РЕЖИМОВ ХИМИОТЕРАПИИ В КОМПЛЕКСНОМ ЛЕЧЕНИИ ТУБЕРКУЛЕЗА С МЛУ/ШЛУ МБТ У ПОДРОСТКОВ

Abstract

Objective: to assess effectiveness of shortened to 12 months chemotherapy regimens containing 4 TB drugs in older children and adolescents with multidrug resistant (MDR) or extensively drug resistant (XDR) pulmonary TB. Materials and methods. We carried out a cohort retrospective study from January 2017 through December 2021. The study enrolled 37 patients aged 13–17 years with various clinical forms of pulmonary TB and established MDR/XDR. The patients were divided into two observation groups: in group 1 (main) 10 patients received continuous treatment containing 4 drugs;in group 2 (comparison) 27 patients received 5-6 drugs during the intensive phase (3 or 6 months) and 3 drugs during the continuation phase (6 or 9 months). The statistical correlation between the risk factor (four-drug chemotherapy regimen) and the outcome (TB relapse) was calculated using the Pearson’s χ2 criterion. The difference p ≤ 0.05 was considered statistically significant. Results. One year after treatment completion we observed 34 out of 37 patients. According to X-ray data, only one (4.2%) of 24 patients of the comparison group developed TB relapse. The comparison of TB relapse incidence in the two groups did not reveal a statistically significant correlation between the risk factor (four-drug chemotherapy regimen) and the outcome (TB relapse) (χ2 = 0.429; р > 0.05). Conclusion. The use of shortened four-drug chemotherapy regimens is an important achievement and changes the approach to treatment of children and adolescents with drug-resistant pulmonary TB.