Background We evaluated the results of treatment in 158 consecutivepatients with multidrug-resistant tuberculosis who were treatedat our center in Istanbul, Turkey.
Methods A total of 21 female patients and 137 male patients(age range, 15 to 68 years) received treatment for multidrug-resistanttuberculosis between March 1992 and October 1999. The patientshad previously received a mean of 5.7 antituberculosis drugsand were infected with organisms that were resistant to a meanof 4.4 drugs. All patients received at least three drugs thoughtto be active; the treatment was continued for at least 18 monthsafter the conversion to a negative culture and for at least24 months in the absence of first-line drugs.
Results The mean number of drugs given during the study was5.5 (range, 3 to 9). Surgical resection was performed in 36patients. Adverse effects led to discontinuation of one or moredrugs in 62 patients (39 percent). Cultures became negativein 150 patients (95 percent) after a mean of 1.9 months (range,1 to 9). The overall success rate of treatment was 77 percent,with cures in 78 patients (49 percent) and probable cures in43 (27 percent). Treatment failed in 13 patients (8 percent).Seven patients died (4 percent). Seventeen patients (11 percent)did not complete the treatment regimen. Thirty-eight percentof the patients with unsuccessful outcomes were infected withorganisms that were resistant to more than five drugs. In astep-down logistic-regression analysis, a successful outcomewas independently associated with a younger age (P=0.013) andthe absence of previous treatment with ofloxacin (P=0.005).
Conclusions Most patients with multidrug-resistant tuberculosiscan be cured with the use of appropriate, intensive treatmentregimens.
Source Information
From the Departments of Pulmonary Disease (K.T., T.T., T.S., G.A., I.O., N.K.) and Thoracic Surgery (A.K.), Sureyyapaa Center for Chest Diseases and Thoracic Surgery; and the Department of Chest Diseases, Istanbul Medicine Faculty, Istanbul University (L.K.) — both in Istanbul, Turkey.
Address reprint requests to Dr. Tahaolu at Ekin Tibbi Yayincilik, Osmanaa Mah. Nüzhet Efendi Sok. No. 49/3, 81320 Kadiköy, Istanbul, Turkey, or at ekinegitim{at}superonline.com.
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a Center for Chest Diseases and Thoracic Surgery; and the Department of Chest Diseases, Istanbul Medicine Faculty, Istanbul University (L.K.) — both in Istanbul, Turkey.
lu at Ekin Tibbi Yayincilik, Osmana
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