[Antituberculous retreatement in case of failure to category I regimen]

In Côte d'Ivoire, since April 2002, the antituberculous regime for category I patients (ARC-I) passed from 2RHZ/4RH to 2RHZE/4RH, without modification of the antituberculous regime for category II (ARC-II) for treatment of cases of the failures to respond to treatment with ARC-I (FARC-I) and patients with a relapse of tuberculosis (TR). The objective of this study was to determine the outcome of patients treated by ARC-II (2RHZES/1RHZE/5RHE).

This study was retrospective and compared outcomes during patient follow-up under ARC-II between 1999-2000 (period 1=267 cases) and 2004-2005 (period 2=434 cases). The ARC-II regime has been prescribed for 297 cases of FARC-I and 404 cases of TR.

The failure rate of the ARC-II regime was estimated to be 11.98% during the first period compared to 5.53% during the second (P<0.001). Among FARC-I cases, therapeutic failure was estimated to 20.54% versus 5.92% in TR group (P<0,001). We noted a positive sputum smear among FARC-I : 16.16% at the second month, 13.13% to the third month and 20.54% at the fifth month versus 4.20% at the second month, 1.48% to the third month and 5.92% at the fifth month within TB cases (P<0.001).

Management of failures to the ARC-I regime must be reviewed to prevent the development of multidrug resistant TB.