Efficiency of treatment with first-line drugs in patients with recurrent tuberculosis of different types of drug resistance on the basis of cohort analysis

Abstract

The purpose of the investigation was to study the efficiency of treatment with essential drugs in patients with recurrent tuberculosis of different types of drug resistance on the basis of cohort analysis. A cohort retrospective study was conducted in 94 patients with recurrent pulmonary tuberculosis. The study enrolled more than 18-year-old bacteria-excreting patients admitted to the Therapeutic Unit, National Center for Tuberculosis Problems, in 2006 to 2008. All the patients received category II chemotherapy regimen with first-line drugs. According to the type of drug resistance, the patients were divided into 3 groups: 1) mono-; 2) poly-; 3) multi-resistance. The investigation yielded the following results. In shorter periods (3 months), sputum smear conversion was achieved in patients with mono- (90.0%), poly- (64.7%), and multi- (32.8%) resistance. Overall, sputum smear conversion at 5 months was achieved in 90.0, 88.1, and 74.5% cases, respectively. Positive X-ray changes as decay cavity reduction (70.0%) and closure (30.0%) were most common in the mono-resistance group. On the contrary, X-ray progression was ascertained in poly- (11.7%) and multi- (16.4%) resistant patients. The cohort analysis showed that the best results of treatment were achieved in mono-resistant patients (90.0%). On the contrary, the worst treatment results were recorded in multi-resistant patients (24.6%). All those who died of tuberculosis (8%) had formed a multi-resistance group.