Abstract
United Kingdom (UK) guidelines recommend at least 18 months treatment for patients with multidrug-resistant tuberculosis (MDR-TB). Prior to 2008, data on treatment outcome were only available at 12 months and therefore the proportion completing treatment was unknown. This retrospective-prospective cohort study reports on treatment outcomes for MDR-TB patients notified between 2004 and 2007 and examines factors associated with successful outcomes. 70.6% (144/204) completed treatment in 24 months or more, 6.9% (14) stopped treatment, 6.9% (14) died, 7.8% (16) were lost to follow up, 0.5% (1) relapsed and 4.4% (9) were transferred overseas. Following adjustment for age, being non-UK born, non-compliance and having co-morbidities, treatment with a fluoroquinolone (OR 3.09; 95% CI 1.21-7.88; p<0.05) or bacteriostatic drug (OR 4.23; 95% CI 1.60-11.18; p<0.05) were independently associated with successful treatment outcome. Treatment completion for MDR-TB cases remains below the World Health Organization (WHO) target. Our findings support current WHO guidelines for MDR-TB treatment. The UK should consider adopting individualised regimens based on WHO recommended drugs, taking into account drug sensitivities. Improving treatment completion rates will be key to tackling further drug resistance and transmission from untreated infectious cases.
Highlights
Multidrug-resistant TB (MDR-TB) remains a threat to the global tuberculosis (TB) control effort [1]
The aims of this study were to determine the number and proportion of MDR-TB patients completing treatment who were diagnosed in the United Kingdom (UK) between 2004 and 2007, to describe the clinical characteristics of patients and to examine factors associated with a successful treatment outcome, loss to follow up and death
There were 204 culture-confirmed cases of MDR-TB diagnosed in the UK between 2004 and 2007
Summary
Multidrug-resistant TB (MDR-TB) remains a threat to the global tuberculosis (TB) control effort [1]. In resource rich settings, initial empirical treatment of MDR-TB patients should be based on past drug resistance results for patients with a previous TB episode, drug resistance profiles of an identified source case, or the levels of background drug resistance in the patient’s country of origin [4,5]. This should be followed by individually adapted drug regimens once drug susceptibility results become available [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
