Treatment results of multi drug resistant tuberculosis, a hospital based study

Abstract

Fukujuji Hospital, Japan. To evaluate treatment results of multi drug resistant tuberculosis cases. Retrospective review of 100 multi drug resistant tuberculosis cases who started treatment in 1990-1999 at Fukujuji Hospital. Life table analysis and analysis of longterm treatment results were done. Observation for more than 3 years after starting treatment revealed cure in 62, chronic excreters in 2, and died cases with positive culture in 10, and treatment completed with shorter observation period in 8. The remaining 18 cases were either transfer-out, defaulted or died with other causes. The older age, cavitary lesions (bilateral>unilateral>no), resistance to more drugs, interruption of treatment due to side effects to second line drugs and the complication of diabetes mellitus were independent risk factors for unfavorable results. The treatment results improved with the increase of the number of effective drugs used for 6 months or more. The surgical intervention improved the proportion of favorable treatment results for those that were culture positive after 5 months of treatment. Treatment results of MDR TB was not satisfactory. Diabetics was the risk factor of unfavorable results. The conditions for the indication of surgical intervention among culture negative cases after 5 months of medical treatment needs to be further investigated.