Abstract
We conducted a systematic review and meta-analysis to assess the evidence for the postulation that inappropriate tuberculosis (TB) regimens are a risk for development of multidrug resistant tuberculosis (MDR-TB).
MEDLINE, EMBASE and other databases were searched for relevant articles in January 2011. Cohort studies including TB patients that received treatment were selected and data on treatment regimen, drug susceptibility testing results and genotyping results before treatment and at failure or relapse were abstracted from the included articles.
Four studies were included in the systematic review, 2 could be included in the meta-analysis.
In these 2 studies the risk for development of MDR-TB in patients who failed treatment and used an inappropriate treatment regimen was 27-fold increased (26.7, 95% Confidence Interval 5.0–141.7) compared to individuals who received an appropriate treatment regimen.
This review provides evidence for the general opinion that development of MDR-TB can be caused by treatment that is inadequate, given the drug susceptibility pattern of the Mycobacterium tuberculosis bacilli. It should be noted that only 2 studies provided data for the meta-analysis. The information can be used to advocate for adequate treatment for patients based on drug resistance profiles.
- ERS
