Follow up of Drug-Resistant Pulmonary Tuberculosis Patients in a DRTB Center in First Fifteen Months of Treatmen

Abstract

Background and Objective: Multidrug-resistant tuberculosis (MDR-TB) is defined as resistant to both INH and Rifampicin with or without resistance to other first-line antitubercular drugs. The aim of the study was to assess the sputum culture conversion rate during first 12 months of treatment in drug-resistant TB patients, to assess the impact of comorbid illnesses and other factors on culture conversion by following up the patients up to 15 months after initiation of treatment. Materials and Methods: This was a prospective study comprising of 142 diagnosed patients of drug-resistant TB admitted in this center from April 2014 to March 2015 for treatment initiation, excluding extrapulmonary TB and already diagnosed extensively drug-resistant tuberculosis (XDR-TB). After pretreatment evaluation, standard second-line antitubercular drug (CAT-IV) was started. Patients were followed up in first 15 months of treatment. Results of sputum culture for mycobacteria at 3rd, 4th, 5th, 6th, 7th, 9th and 12th months after treatment initiation were analyzed. Results: Sputum culture for mycobacteria was converted negative within one year in 95 cases (67%); whereas 18 patients died during follow up, 27 defaulted and 2 patients switched over to CAT-V after development of extended drug-resistance during follow up. Conclusion: Though drug-resistant tuberculosis (DRTB) is one of the biggest challenges to public health program in India, treatment with standardized second-line drugs under RNTCP have a favorable outcome as indicated by sputum culture conversion of as many as 67% of patients within one year in this study.