Original Article
Factors associated with treatment outcome in 64 HIV negative patients with multidrug resistant tuberculosis
Abstract
Objectives: In this study we aimed to determine the factors associated with treatment outcome in HIV negative patients with multidrug resistant tuberculosis (MDR TB).
Materials and methods: The study comprised 64 (43 female and 21 male) patients in whom second line TB drugs were administered in directly observed treatment (DOT) programme. Achievement of sputum AFB (acid fast bacilli) negativity in the 3rd month of the treatment was accepted as the bacteriologic response. Treatment outcome of the patients and the factors influencing the bacteriologic response were evaluated.
Results: The mean time of sputum smear negativity was determined as 3±2.2 months. Bacteriologic response was determined in 73.4% of the patients. The mean duration time of the treatment was 16.4±8.2 months. Treatment outcome of the patients was determined as cure in 34 (53.1%), default in 18 (28.1%), treatment failure in 1 (1.6%) and exitus in 3 (4.7%) patients. Also, in 8 (12.5%) patients treatment was incomplete and continued. Adverse effects of the drugs were seen in 39 (60.9%) patients with the most frequency of gastrointestinal disturbance (51.5%), psychiatric disorders (15.6%), dermatological effects (12.5%). In logistic regression analysis only presence of cavity and the extensive disease were found to be associated with poor bacteriologic response (OR=1.5, 95% CI: 1.23-1.82, P=0.01 and OR=2, 95% CI: 1.42-2.79, P=0.00, respectively).
Conclusions: Although radiological findings might affect the bacteriologic response, MDR TB is a treatable disease if regular and appropriate treatment regimen is administered.
Materials and methods: The study comprised 64 (43 female and 21 male) patients in whom second line TB drugs were administered in directly observed treatment (DOT) programme. Achievement of sputum AFB (acid fast bacilli) negativity in the 3rd month of the treatment was accepted as the bacteriologic response. Treatment outcome of the patients and the factors influencing the bacteriologic response were evaluated.
Results: The mean time of sputum smear negativity was determined as 3±2.2 months. Bacteriologic response was determined in 73.4% of the patients. The mean duration time of the treatment was 16.4±8.2 months. Treatment outcome of the patients was determined as cure in 34 (53.1%), default in 18 (28.1%), treatment failure in 1 (1.6%) and exitus in 3 (4.7%) patients. Also, in 8 (12.5%) patients treatment was incomplete and continued. Adverse effects of the drugs were seen in 39 (60.9%) patients with the most frequency of gastrointestinal disturbance (51.5%), psychiatric disorders (15.6%), dermatological effects (12.5%). In logistic regression analysis only presence of cavity and the extensive disease were found to be associated with poor bacteriologic response (OR=1.5, 95% CI: 1.23-1.82, P=0.01 and OR=2, 95% CI: 1.42-2.79, P=0.00, respectively).
Conclusions: Although radiological findings might affect the bacteriologic response, MDR TB is a treatable disease if regular and appropriate treatment regimen is administered.
