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Management of multiple drug-resistant tuberculosis
D C S Hutchison1, F A Drobniewski, H J Milburn
1Department of Respiratory Medicine, King's College Hospital, London, UK.
Respiratory Medicine
|January 31, 2003
Summary
Treatment for drug-resistant tuberculosis (MDR-TB) in London yielded good outcomes for most patients. Specialized care improved prognosis, showing better results than previously thought for MDR-TB management.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Worldwide increase in multiple drug-resistant tuberculosis (MDR-TB).
- Historically associated with poor prognosis.
- Focus on London cases due to concentration.
Purpose of the Study:
- Investigate treatment and outcomes of MDR-TB patients in South London.
- Examine risk factors, drug resistance, and treatment protocols.
- Assess sputum conversion and patient prognosis.
Main Methods:
- Retrospective study of MDR-TB patients (HIV-negative) in South London (June 1995-Jan 1999).
- Analysis of 13 MDR-TB patients regarding demographics, drug resistance, and treatment regimens.
- Follow-up of 8 patients for at least 3 years post-treatment.
Main Results:
- MDR-TB patients were predominantly young, foreign-born, with pulmonary disease.
- Organisms showed resistance to a median of 2 first-line and 4 total drugs.
- Treatment involved a median of 6 drugs.
- 8/13 patients achieved disease-free survival with sputum negativity at long-term follow-up.
- 1 patient died due to treatment failure.
Conclusions:
- Disease-free survival achieved in 8/13 HIV-negative MDR-TB patients followed for 3+ years.
- Prognosis for MDR-TB patients treated at specialized centers is favorable.
- A new protocol for MDR-TB detection and management was described.