Outcome of multi-drug resistant tuberculosis cases treated by individualized regimens at a tertiary level clinic.

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dc.contributor.authorDhingra, V Ken_US
dc.contributor.authorRajpal, Sen_US
dc.contributor.authorMittal, Anshuen_US
dc.contributor.authorHanif, Men_US
dc.date.accessioned2008-01-26en_US
dc.date.accessioned2009-06-01T12:25:35Z
dc.date.available2008-01-26en_US
dc.date.available2009-06-01T12:25:35Z
dc.date.issued2008-01-26en_US
dc.description.abstractAIM: To determine the clinical, radiological and drug resistance profile as well as the factors associated with treatment outcome of Multi-Drug Resistant Tuberculosis (MDR-TB). MATERIAL AND METHODS: All newly diagnosed patients with pulmonary MDR-TB from August 2002 to December 2004 enrolled at New Delhi Tuberculosis Centre, were included in the study. They were followed up clinically, radiologically and bacteriologically by sputum smear, culture and Drug Susceptibility Testing (DST) at regular intervals. According to their DST pattern and previous history of Anti-Tubercular Treatment (ATT), individualized treatment regimens were tailored for each patient. RESULTS: Out of total 27 bacteriologically proven cases of MDR-TB included in this study, 19 were males (mean age and weight 38.5 years and 52.6 kgs, respectively) and eight females (mean age and weight 34.3 years and 40.7 kgs, respectively). A majority (18) were residents of Delhi and the rest hailed from different parts of North India. All of them had a history of previous treatment ranging from six to 34 months. Cavity on chest X-rays was seen in 81%, while 44% showed extensive involvement. The patients received at least four "second line drugs" during their treatment with a mean of 6.2 anti-tubercular drugs during their intensive phase. Of the 27 patients, 13 were cured, 10 defaulted, one died, one is still on treatment and two were referred for surgery. Radiological improvement was observed in two third of cases and chest X-ray of two patients showed a complete resolution. Six predictors were identified for successful outcome of MDR-TB. They include weight gain at six months, culture conversion, radiological improvement during treatment, disease with M. tuberculosis strains exhibiting resistance to less than or up to three anti-tubercular drugs, use of less than or up to three second line drugs in treatment and no change of regimen during treatment. CONCLUSION: Default from treatment was observed to be a major challenge in the treatment of MDR-TB due to long duration and expense of ATT.en_US
dc.description.affiliationNew Delhi Tuberculosis Centre, Jawaharlal Nehru Marg, New Delhi-110 002.en_US
dc.identifier.citationDhingra VK, Rajpal S, Mittal A, Hanif M. Outcome of multi-drug resistant tuberculosis cases treated by individualized regimens at a tertiary level clinic. Indian Journal of Tuberculosis. 2008 Jan; 55(1): 15-21en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/110541
dc.language.isoengen_US
dc.source.urihttps://medind.nic.in/ibr/ibrai.shtmlen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAminoglycosides --administration & dosageen_US
dc.subject.meshAntitubercular Agents --administration & dosageen_US
dc.subject.meshChilden_US
dc.subject.meshCycloserine --administration & dosageen_US
dc.subject.meshEthambutol --administration & dosageen_US
dc.subject.meshFemaleen_US
dc.subject.meshFluoroquinolones --administration & dosageen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMicrobial Sensitivity Testsen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPyrazinamide --administration & dosageen_US
dc.subject.meshSeverity of Illness Indexen_US
dc.subject.meshThioamides --administration & dosageen_US
dc.subject.meshTime Factorsen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshTuberculosis, Multidrug-Resistant --drug therapyen_US
dc.subject.meshp-Aminosalicylic Acid --administration & dosageen_US
dc.titleOutcome of multi-drug resistant tuberculosis cases treated by individualized regimens at a tertiary level clinic.en_US
dc.typeJournal Articleen_US
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