Factors influencing treatment efficacy in patients with multiple and extensive drug resistant tuberculosis

Abstract

The objective: to determine factors influencing treatment efficacy in patients with multiple (MDR) and extensive (XDR) drug resistant tuberculosis.

Subjects and methods. The medical files of 107 tuberculosis patients (men – 75, women – 32) were analyzed, 17 of them were HIV positive. Those 107 patients were registered for treatment as per chemotherapy (CT) regimens IV-V in 2017 in Kaluga Region. 99 (92.5%) patients suffered from tuberculosis with lung tissue destruction. 60.7% (65 patients) had MDR, while 20.8% (22 patients) had XDR. Only 58.2% of patients had MDR TB confirmed by polymerase chain reaction before treatment start.

Results. In 24 months, the effective course of treatment was registered in 64/107 (59.8%). The highest level of effective treatment was expectedly registered among new cases – 21/30 (70%); and the lowest level was among patients starting chemotherapy again after treatment interruption – 4/10 (40%), p > 0.05. Among 64 patients with effective treatment course, 25 (39.1%) had surgery and 39 (60.9%) had chemotherapy only. Surgical activity among the cohort of 2017 made 26/107 (24.3%). The effective treatment outcome was achieved in 8 (47%) out of 17 patients with TB/HIV co-infection, and among HIV negative patients it was reached in 56/90 (62.2%), p > 0,05.