Outcome of pulmonary multidrug-resistant tuberculosis: a 6-yr follow-up study

被引:98
作者
Chiang, C-Y.
Enarson, D. A.
Yu, M-C.
Bai, K-J.
Huang, R-M.
Hsu, C-J.
Suo, J.
Lin, T-P.
机构
[1] Int Union Against TB & Lung Dis, F-75006 Paris, France
[2] Taipei Med Univ, Municipal Wang Fang Hosp, Taipei, Taiwan
[3] Chest Hosp, Dept Hlth, Tainan, Taiwan
[4] Natl TB Assoc, Taipei, Taiwan
关键词
death; follow-up; multidrug resistant; relapse; tuberculosis;
D O I
10.1183/09031936.06.00125705
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
A retrospective study was performed to determine factors associated with the outcome of pulmonary multidrug-resistant tuberculosis (MDR-TB) in Taipei, Taiwan. All patients newly diagnosed with pulmonary MDR-TB in a referral centre from 1992-1996 were enrolled and their outcome over the subsequent 6 yrs was determined. A total of 299 patients were identified, comprising 215 (71.9%) males and 84 (28.1%) females with a mean age of 47.3 yrs. The patients received a mean of 3.7 effective drugs. Out of the 299 patients, 153 (51.2%) were cured, 31 (10.4%) failed, 28 (9.4%) died and 87 (29.1%) defaulted. Of the 125 patients receiving second-line drugs with ofloxacin, 74 (59.2%) were cured. Those who received ofloxacin had a lower risk of relapse than those receiving only first-line drugs (hazard ratio (HR) 0.16, 95% confidence interval (CI) 0.03-0.81) and a lower risk of TB-related death than those receiving second-line drugs but not ofloxacin (adjusted HR 0.509 95% Cl 0.31-0.82). In conclusion, multidrug-resistant tuberculosis patients who received ofloxacin were more likely to be cured, and were less likely to die, fail or relapse. The utility of new-generation fluoroquinolones, such as moxifloxacin, in the treatment of multidrug-resistant tuberculosis needs to be evaluated. Default from treatment is a major challenge in the treatment of multidrug-resistant tuberculosis.
引用
收藏
页码:980 / 985
页数:6
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