Influence of drug susceptibility on treatment outcome and susceptibility profile of ‘failures' to category II regimen.

Joseph, P.; Chandrasekaran, V.; Thomas, A.; Gopi, P.G.; Rajeswari, R.; Balasubramanian, R.; Subramani, R.; Selvakumar, N.; Santha,T.

Indian Journal of Tuberculosis; 2006; 53; 141-148.

Summary: Objective : To assess the influence of drug resistance on treatment outcome among patients treated with Category-II regimen and document drug susceptibility pattern of “Failures” to this regimen.

Design : A retrospective analysis of patients registered from May 1999 through December 2004.

Results : Treatment success was 42% among 572 patients and was similar among patients with fully susceptible or resistant but non-MDR organisms (41% of 254 and 40% of 128 patients, respectively). Among 49 MDR-TB patients, 27% had successful treatment outcome. The failure rates among patients with fully susceptible, resistant but non-MDR and MDR bacilli, were 6%, 12% and 27% respectively. Default was significantly higher among males (53% vs . 34%: p<0.01) smokers (57% vs . 36%: p<0.001), alcoholics (58% vs. 39%: p <0.001) and patients with higher initial smear grading (2+ or 3+, 56% vs. scanty or 1+, 44%: p <0.01). DST results were available for 60% (31 of 52) of failures and 10 had MDR-TB.

Conclusion : The low success rate to the re-treatment regimen was mainly due to non-compliance. Failure was observed among 9% of patients and MDR-TB was 32% among Category II failures. The currently recommended Category II regimen appears to be adequate for majority of re-treatment cases.

Keywords : Treatment outcome, Category II regimen, failure, RNTCP, MDR-TB

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