Management of multidrug resistant tuberculosis (MDR-TB) – Monitoring is the key to successful outcome

Abstract

ContextTreatment of multidrug resistant tuberculosis (MDR-TB) is challenging. In India, standard treatment regimen is established by Revised National Tuberculosis Control Programme (RNTCP). Adequate follow-up of patients during the treatment period is a challenging task under programmatic conditions. We did a retrospective analysis of patients enrolled and treated under the national programme to study the outcome. AimsTo study the treatment outcome of MDR-TB and the factors affecting it. Settings and designRetrospective analysis of 69 patients treated with standard regimen for MDR-TB, as per RNTCP guidelines. Methods and materialRetrospective analysis of 69 MDR-TB patients for the clinical and demographic profile. Treatment outcome is defined as cure rate, default rate, death rate and failure. The factors affecting this outcome are also studied. ResultsSputum culture conversion rate was 33.9% and 62.5% at 3rd and 6th month of treatment respectively. Cure rate was 47.8%, death rate 27.5%, default rate 14.5% and failure 7.3%. ConclusionsThe major hindrance in achieving a good cure-rate was a high death rate and default. Early diagnosis of MDR-TB and adequate clinical monitoring during treatment is essential. Identifying adverse drug reactions, other co morbidities and their optimal management is the key to success.