Abstract
BackgroundVarious studies have reported culture conversion at two months as a predictor of successful treatment outcome in multidrug-resistant tuberculosis (MDR-TB).ObjectivesThe present study was conducted with the aim to evaluate the rate and predictors of culture conversion at two months in MDR-TB patients.MethodsAll confirmed pulmonary MDR-TB patients enrolled for treatment at Lady Reading Hospital Peshawar, Pakistan from 1 January to 31 December 2012 and met the inclusion criteria were reviewed retrospectively. Rate and predictors of culture conversion at two months were evaluated.ResultsEighty seven (53.4%) out of 163 patients achieved culture conversion at two months. In a multivariate analysis lung cavitation at baseline chest X-ray (P = 0.006, OR = 0.349), resistance to ofloxacin (P = 0.041, OR = 0.193) and streptomycin (P = 0.017, OR = 0.295) had statistically significant (P<0.05) negative association with culture conversion at two months.ConclusionA reasonable proportion of patients achieved culture conversion at two months. Factors negatively associated with culture conversion at two months can be easily identified either before diagnosis or early in the course of MDR-TB treatment. This may help in better care of individual patients by identifying them early and treating them vigorously.
Highlights
Multi drug resistant tuberculosis (MDR-TB) involves prolonged treatment, expensive and toxic regimens, more potent sources of infection for others, and reflects higher rates of treatment failure as compared to drug susceptible TB [1]
Factors negatively associated with culture conversion at two months can be identified either before diagnosis or early in the course of multidrug-resistant tuberculosis (MDR-TB) treatment
Better treatment outcomes have been observed in MDR-TB patients who achieved culture conversion at two months in a study conducted in Dominican Republic [8]
Summary
Multi drug resistant tuberculosis (MDR-TB) involves prolonged treatment, expensive and toxic regimens, more potent sources of infection for others, and reflects higher rates of treatment failure as compared to drug susceptible TB [1]. Culture conversion has been widely reported as a predictor of treatment success in both susceptible and drug resistant TB [6,7,8,9,10]. Culture conversion at two months has widely been reported as a strong predictor and early indicator of treatment success in drug susceptible TB [9,10,11]. Better treatment outcomes have been observed in MDR-TB patients who achieved culture conversion at two months in a study conducted in Dominican Republic [8]. On the other hand poor treatment outcomes have been reported in MDR-TB patients who failed to achieve culture conversion at two months [10]. Various studies have reported culture conversion at two months as a predictor of successful treatment outcome in multidrug-resistant tuberculosis (MDR-TB)
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