Traditional and Short Course Treatment for Multidrug-Resistant Tuberculosis: A Comparative Study in National Referral...

Area of Science:

• Infectious Diseases
• Pulmonology
• Clinical Pharmacology

Background:

• Multidrug-resistant tuberculosis (MDR-TB) treatment presents significant challenges due to its difficulty, cost, and lengthy duration.
• Recent recommendations suggest exploring shorter therapeutic regimens, typically lasting 9 months to one year, as an alternative to traditional prolonged treatments.
• Evaluating the efficacy and safety of these shorter MDR-TB treatment options is critical for improving patient outcomes and treatment adherence.

Purpose of the Study:

• To compare the treatment response of a shorter therapeutic regimen against a traditional longer regimen in patients diagnosed with MDR-TB.
• To assess key indicators such as smear and sputum culture conversion, treatment outcomes, and relapse rates between the two treatment groups.
• To identify and evaluate any severe adverse effects associated with either the shorter or longer MDR-TB treatment regimens.

Main Methods:

• A randomized study involving 48 MDR-TB patients, divided equally into shorter and longer regimen groups.
• The shorter regimen included Moxifloxacin, Prothionamide, Amikacin, Clofazimine, Linezolid, Ethambutol, Pyrazinamide, and Cycloserine.
• The longer regimen included the same drugs, excluding Clofazimine and Linezolid, with patients monitored for complications and followed for five years for relapse.

Main Results:

• The median interval for smear conversion was shorter in the short-course group (36 days) compared to the standard group (49 days).
• Severe adverse effects were observed in 8 out of 12 patients, with a higher incidence in the shorter regimen group.
• No significant difference in the overall treatment outcome or relapse rates was observed between the shorter and longer treatment groups after three years.

Conclusions:

• Shorter treatment regimens for MDR-TB may enhance cure rates, patient cooperation, and adherence.
• Consideration of shorter regimens within national TB programs could strengthen favorable treatment outcomes.
• While effective, the increased incidence of severe adverse effects in the shorter regimen warrants careful monitoring and management.