[Reasons for chronic sputum culture positive tuberculosis--evaluation based on personal experience]

It is commonly believed that chronic sputum positivity in treated pulmonary tuberculosis is caused by the patients' noncompliance. We have undertaken retrospective analysis of the records of 59 patients to verify reasons of treatment failure. The group consisted of 12 women and 47 men aged between 22 to 87 (median: 47) who were sputum culture positive from 1 to 12 years (x = 3.4). According to the retrospective analysis 44 patients showed more than one reason for treatment failure. In 36 cases improper therapy was responsible for treatment failure involving insufficient number of drugs in 28 cases, untimely termination of treatment in 14 cases, inadequate drugs in 11 cases, poor control of treatment in 5 cases and insufficient doses of drugs in 1 case. The patients' noncompliance was the main reason in 33 cases, allergy and adverse reaction to drugs were the reasons of failure of the therapy in 21 cases. 18 patients (30.5%) showed primary drug resistance. The patients' records analysis revealed that the drug resistance rate was related to the duration of treatment. At the beginning every patient was resistant to 2 drugs on average while at the end of the treatment the number increased to 4. In spite of this only 31 patients (52.5%) received other than first line drugs.