RT Journal Article
SR Electronic
T1 Drug resistance pattern of directly observed treatment shortcourse (DOTS) category-II relapse patients
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p2644
VO 38
IS Suppl 55
A1 Nirmal Jain
A1 Mukesh Sharma
A1 Nitin Jain
A1 Nalin Joshi
A1 Rohan Aurangabadwalla
A1 Akanksha Jha
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p2644.abstract
AB Background: Multi-Drug resistance (MDR) is an emerging threat to tuberculosis control and resistance pattern depends on factors like regimen, duration of treatment, compliance etc. Currently Cat-II relapses are retreated with Cat-II DOTS and there is scarcity of data on drug resistance pattern in relapse patients.Materials and method: This prospective observational study included 128 patients of Cat-II relapse. Detailed history of chemotherapy was recorded and sputum was sent for mycobacterial culture and sensitivity before starting Cat II DOTS. Resistance pattern of patient was studied.Results: 122 out of 128 culture and sensitivity reports were available. 104 (85%) patients were culture positive, 15 (12.09%) were smear positive and culture negative. 3 (2.41%) had contaminated culture. 86 (69.35%) patients had resistance to any drug, of which 66 (53.22%) were MDR.112 (87%) and 16 (13%) patients were treated previously with DOTS and non-DOTS respectively. History of previous chemotherapy revealed 80 (63%) patients had relapses, 11 (9%) were failures and 37 (29%) were defaulters. 56 (73%) had resistance to any drug and, 42 (54%) were MDR in relapse group. 7 (70%) patients had resistance to any drug in failure group and all were MDR. 57% had resistance to any drug in defaulters and 50% were MDR.Conclusions: High resistance pattern (53.22%) in Cat II relapse patients, thus patients should not be retreated with Cat-II retreatment regimen but empirically treated with revised line drugs till availability of mycobacterial culture and sensitivity reports. There is scarcity of drug resistance data for Cat-II relapses and an urgent need of generating data on relapses so that the policy to treat these patients can be established.