Is short-course therapy enough at drug-resistant tuberculosis?

Objective & Hypothesis:Introduction: Tuberculosis drug resistance can be assessed by physicians with different approaches on issues such as the choice of treatment protocol and duration of treatment.

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Key Findings & Data:The 167 culturepositive patients with nonMDR-TB drug resistance diagnosed between 2008-2010 were analyzed retrospectively.

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Conclusion & Impact:Patients with Non MDR-TB drug resistance should be monitored well and should be careful in terms of MDR-TB.

🔬Design:Research Article

📍Scope:2008-2010 Verileri

⚙️Variables:Domain Parameters

Abstract

Introduction: Tuberculosis drug resistance can be assessed by physicians with different approaches on issues such as the choice of treatment protocol and duration of treatment. Materials and Methods: In this study, we aimed to evaluate the treatment regimens and treatment results of patients with non multidrug resistant tuberculosis (MDR-TB) drug resistance implemented in different chest disease clinics in our hospital. The 167 culturepositive patients with nonMDR-TB drug resistance diagnosed between 2008-2010 were analyzed retrospectively. Patients’ age, gender, previous TB treatments, bacteriological cruise, drug resistance patterns and treatment outcomes were analyzed. Results: One hundred sixty-seven patients with eligible data were evaluated; there were 117 (70.1%) men and 50 (29.9%) women, mean age was 42.35 (18-90) years, respectively. Among mono drug resistance; H resistance in 75 (44.9%) patients and R resistance in 11 patients was detected. In 19 (11.4%) patients HS resistance was detected as multiple drug resistance. One hudred and twentyfive (74.9%) were new cases. When treatment the results of in all patients evaluated, 136 (81.4%) of the patients achieved treatment success. Sixty-four (51.2%) of the new TB cases treated with “standard treatment protocols for new cases“ (2HRZE/4H) and 51 (40.8%) of them treated with “other treatment protocols”. Ten (23.8%)of the recurrent TB cases” standard treatment for recurrent cases (2HRZES/HRZE/5HRE) and 9 (21.4%) 33 (19.8%) of them treated with other protocols. The combination of the rthe treatment protocol and descriptive information about the duration of the treatment could not be created as 33 (19.8%) of the cases left without completing their treatment. Conclusion: As a result of the analysis, patients have completed their treatment, there was no significant difference in treatment outcomes. Patients with Non MDR-TB drug resistance should be monitored well and should be careful in terms of MDR-TB.

Özet

Giriş: Tüberkülozda ilaç direnci, tedavi protokolü seçimi, tedavi süresi gibi konularda hekimler tarafından farklı yaklaşımlarla değerlendirilebilmektedir. Çalışmamızda hastanemizin farklı kliniklerinde uygulanan çok ilaca dirençli tüberküloz (ÇİD-TB) harici ilaçdirencine karşı kullanılan farklı tedavi rejimlerini ve tedavi sonuçlarının değerlendirilmesi amaçlandı.Materyal ve Metod: 2008-2010 yılları arasında; ilaç direnç testinde ÇİD-TB harici ilaç direnci saptanan, 167 kültür pozitif hasta retrospektif olarak incelendi. Hastaların yaş, cinsiyet, almış oldukları tedaviler, bakteriyolojik seyirleri, tüberküloz tedavi öyküsü, ilaçdirenci paternleri ve tedavi sonuçları incelendi.Bulgular: Hastaların 117’si (%70.1) erkek ve 50’si (%29.9) ise kadındı, yaş ortalamaları 42.35 (18-90) olarak saptandı. Tek ilaçdirençlerinde, 75 (%44.9) hastada H direnci ve 11 hastada R direnci saptandı. Çoklu ilaç direncinde ise 19 (%11.4) hastada HSdirenci saptandı. Hastaların 125’i (%74.9) yeni olgu ve 42’si (%25.1) eski olguydu. Hastaların 125’inde (%74.9) hem mikroskopihem kültür pozitifliği saptanırken, 42 (%25.1) hastada sadece kültür pozitifliği saptandı. Tüm hastalarda tedavi sonuçlarına değerlendirildiğinde; hastaların 136’sında (%81.4) tedavi başarısı sağlandığı gözlendi. Yeni hastaların; 64’üne (%51.2) “yeni olgularda standart tedavi protokolleri” (2HRZE/4HR), 51’ine (%40.8) “yeni olgularda diğer tedavi protokolleri” (2HRZE/4HR harici en az 6 aylıktedavi protokolü) uygulanmıştır. Eski hastaların ise 10’una (%23.8) “eski olgularda standart tedavi protokolleri” (2HRZES/HRZE/5HRE), 9’una (%21.4) ise “eski olgularda diğer tedavi protokolleri” (2HRZES/HRZE/5HRE harici en az 8 aylık tedavi protokolü) uygulanmıştır. Toplam hastaların 33’ünün (%19.8) ise tedavilerini sonlandırmadıkları için, uygulanan rejimin kombinasyonu vesüresi konusunda tanımlayıcı bir bilgi oluşturulamadı.Sonuç: Çalışmanın sonucunda, tedavilerini tamamlayanlar hastalarda, tedavi sonuçları açısından anlamlı fark bulunmadı. ÇİD-TBharici ilaç direncine sahip hastaların tedavi süreçleri iyi izlenmeli veÇİD-TB açısından dikkatli olunmalıdır.

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Cite This Article

YILDIRIM, E. Ö., ÖZMEN, İ., TÖRÜN, T., ÇALIŞIR, H. C., OGUN, H. (2022). Is short-course therapy enough at drug-resistant tuberculosis?. Tüberküloz ve Toraks, Cilt: 66 - Sayı: 4, 280–287. https://ajindex.com/articles/618478

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