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Int J Tuberc Lung Dis. 2000 Jun;4(6):544-9.

Treatment monitoring and prevalence of drug resistance in tuberculosis patients in Tehran.

Author information

1
Department of Mycobacteriology, Pasteur Institute of Iran, Tehran, Islamic Republic of Iran. bakayev@institute.pasteur.ac.ir

Abstract

SETTING:

Health care clinics and private practitioners in Tehran.

OBJECTIVE:

To analyse rates of drug resistance and response to treatment in tuberculosis patients.

DESIGN:

A prospective study of 257 patients undergoing treatment for whom data were collected on drug susceptibility testing and outcome as well as age, sex and history of treatment.

RESULTS:

Of 774 initially diagnosed patients, 380 were female and 394 were male; 520 (67%) of the cases had pulmonary disease. The overall rate of primary drug resistance among Mycobacterium tuberculosis isolates resistant to at least one drug was 87/563 (15.5%). Twenty-three patients were multidrug-resistant. Among 215 patients with drug-susceptible cultures recruited for follow-up, rapid response to short-course chemotherapy was observed in 190 (88%) who were successively both smear and culture negative after 2 and 4 months of treatment. After 6 months of treatment, 12 of the 25 patients with slow response to treatment had positive cultures; one was smear-positive. Of the 42 patients with drug-resistant isolates, satisfactory bacteriological response was observed after 6 months of treatment in 30 (71%).

CONCLUSIONS:

These observations support regional recommendations for short-course treatment regimens. Culture rather than smear result could be a key parameter for individually guiding the duration of treatment in patients with poor response to treatment.

PMID:
10864185
[Indexed for MEDLINE]

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