ORIGINAL ARTICLE
Year : 2017  |  Volume : 10  |  Issue : 1  |  Page : 41-45

Treatment outcomes of drug-resistant pulmonary tuberculosis under programmatic management of multidrug-resistant tuberculosis, at tertiary care center in Mumbai


Department of Pulmonary Medicine, T. N. Medical College, B. Y. L. Nair Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Jyotsna M Joshi
Department of Pulmonary Medicine, T. N. Medical College, B. Y. L. Nair Hospital, Mumbai - 400 008, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.197892

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Background: This study was undertaken to analyze the clinical profile and treatment outcome in pulmonary drug-resistant tuberculosis (TB) patients under programmatic management of multidrug-resistant tuberculosis (PMDT) at a tertiary care center in Mumbai. Methodology: A retrospective study was conducted at PMDT site of a tertiary care hospital. The data of 194 pulmonary multidrug-resistant (MDR) TB patients diagnosed at our hospital or prediagnosed patients referred to our hospital were meticulously reviewed to study demography, baseline drug susceptibility to first- and second-line drugs, treatment outcomes, comorbidities, and adverse drug reactions (ADRs). Results: Out of 194 patients, 48.4% (68 cured + 26 treatment completed) were successfully treated, 22 (11.3%) failed on therapy, 39 (20.15%) patients died, 23 (11.8%) defaulted, 26 (13.4%) completed treatment with outcomes unknown, 13 (6.7%) were transferred out and in 3 patients (1.5%) treatment was stopped due to ADRs. Most common ADRs were gastrointestinal 32 (16.4%) and psychiatric 37 (19%). However, there was no statistical significance between the prevalence of ADRs and unfavorable outcomes. Most common comorbidities were GERD 27 (40.2%) and diabetes mellitus 22 (32.8%). Conclusion: Baseline drug susceptibility testing (DST) with rapid diagnostic tests, performing DST for second-line drugs, i.e., fluoroquinolones and aminoglycoside and modification of treatment regimen based on the same at start of MDR treatment has prime importance. Early detection of ADR's and comorbidities and their prompt treatment are also equally important.


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