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Published online before print July 12, 2006
Eur Respir J 2006, doi:10.1183/09031936.06.00125705
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ORIGINAL ARTICLE

Outcome of pulmonary multidrug-resistant tuberculosis: a six year follow-up study

C-Y. Chiang 1, D.A. Enarson 1*, M-C. Yu 2, K-J. Bai 2, R-M. Huang 3, C-J. Hsu 4, J. Suo 4, T-P. Lin 4

1 International Union Against Tuberculosis And Lung Disease, Paris, France
2 Taipei Medical University-Municipal Wan Fang Hospital, Taipei, Taiwan
3 Chest Hospital, Dept of Health, Tainan, Taiwan
4 National Tuberculosis Association, Taipei, China

* To whom correspondence should be addressed. E-mail: denarson{at}iuatld.org.


  Abstract

We performed a retrospective study to determine factors associated with outcome of pulmonary multidrug-resistant tuberculosis (MDR-TB) in Taipei, Taiwan.

All patients newly diagnosed with pulmonary MDR-TB in a referral center from 1992 through 1996 were enrolled and their fate over the subsequent six years determined.

A total of 299 patients were identified. They were 215(71.9%) male and 84(28.1%) female with a mean age of 47.3 years. The patients received a mean of 3.7 effective drugs. Of the 299 patients, 153(51.2%) were cured, 31(10.4%) failed, 28(9.4%) died, and 87(29.1%) defaulted. Of the 125 patients receiving second line drugs with ofloxacin, 74(59.2%) were cured. Those who received ofloxacin had a lower risk of relapse than those received only first line drugs (Hazard Ratio (HR) 0.16, 95%CI 0.03-0.81) and a lower risk of tuberculosis-related death than those received second line drugs but not ofloxacin (adjusted HR 0.50, 95%CI 0.31-0.82).

In conclusion, MDR-TB patients who received ofloxacin were more likely to be cured, and were less likely to die, fail and relapse. The utility of new generation fluoroquinolones such as moxifloxacin in the treatment of MDR-TB needs to be evaluated. Default from treatment is a major challenge in the treatment of MDR-TB.

Keywords:  Death, follow-up, multidrug-resistant, relapse, tuberculosis




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D. H. Kim, H. J. Kim, S.-K. Park, S.-J. Kong, Y. S. Kim, T.-H. Kim, E. K. Kim, K. M. Lee, S. S. Lee, J. S. Park, et al.
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Am. J. Respir. Crit. Care Med., November 15, 2008; 178(10): 1075 - 1082.
[Abstract] [Full Text] [PDF]


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