Title:Treatment Outcomes of the Standardized Shorter MDR-TB Regimen Under
Programmatic Setting: A Retrospective Study from a Tertiary Care
Centre, India
Volume: 18
Issue: 1
Author(s): K.M.P Swathi, M. Somashekar, A. Chakraborty, R. Swapna*, J.S. Akshata and C. Nagaraja
Affiliation:
- Department of Pulmonary Medicine, SDS TRC & Rajiv Gandhi Institute of Chest Diseases, Bangalore, Karnataka, India
Keywords:
Alopecia, DRTB, PMDT, relapse, sputum conversion, treatment outcome.
Abstract:
Background: The shorter regimen was widely accepted and advocated for MDR-TB
treatment compared tothe conventional longer regimen. Evaluating the performance of both regimens
in a programmatic setting will help in tailoring the treatment regimen of MDR-TB.
Objectives: To estimate the duration of sputum smear conversion in the shorter MDR-TB regimen.
2. To compare the treatment outcomes of the shorter MDR-TB regimen with that of the longer conventional
MDR regimen in a programmatic set up in India. 3. To estimate the adverse drug reactions
in the shorter MDR-TB regimen.
Methods: A retrospective cross-sectional study was conducted on 320 patients enrolled under programmatic
management of drug resistant tuberculosis (PMDT) from April 2017 to May 2019 at a
nodal DRTB center and a tertiary care hospital in India. Demographic and clinical characteristics
of those who received a shorter MDR-TB regimen were recorded. Treatment outcomes of both regimens
were recorded. Treatment success is defined as ‘disease cured and treatment completed’,
whereas treatment failure was considered when the treatment was either terminated or changed due
to lack of bacteriological conversion at the end of an extended intensive phase or culture reversion
in the continuation phase.
Results: The treatment success observed in the shorter MDR-TB regimen was 61.25%, which was
significantly higher than the conventional longer regimen (p=0.0007). Treatment failures were higher
with a shorter MDR-TB regimen (p=0.0001).
Conclusion: Treatment success with the shorter MDR-TB regimen though higher than the conventional
regimen, is still way behind the target treatment success rate. Improving treatment adherence
remains pivotal for achieving end TB targets.
