Abstract
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.
- © 2011 ERS