Tuberc Respir Dis.  2009 Mar;66(3):198-204. 10.4046/trd.2009.66.3.198.

Acquired Drug Resistance during Standardized Treatment with First-line Drugs in Patients with Multidrug-Resistant Tuberculosis

Affiliations
  • 1National Masan Tuberculosis Hospital, Masan, Korea. sooli10kr@yahoo.co.kr
  • 2International Tuberculosis Research Center, Masan, Korea.

Abstract

BACKGROUND: First-line drugs, if sensitive, are the most potent drugs in the treatment of multidrug-resistant tuberculosis (MDR-TB). This study examined the frequency and risk factors associated with acquired drug resistance to first-line drugs during a standardized treatment using first-line drugs in patients with MDR-TB.
METHODS
This study included patients who were diagnosed with MDR-TB at the National Masan Tuberculosis Hospital between January 2004 and May 2008, treated with standardized first-line drugs, and for whom the preand post-treatment results of the drug susceptibility test were available. Their medical records were reviewed retrospectively.
RESULTS
Of 41 MDR-TB patients, 14 (34.1%) acquired additional resistance to ethambutol (EMB) or pyrazinamide (PZA). Of 11 patients initially resistant to isoniazid (INH) and rifampicin (RFP), 3 (27.3%) acquired additional resistance to both EMB and PZA, and 3 (27.3%) to PZA. Of 18 patients initially resistant to INH, RFP and EMB, 6 (33.3%) acquired additional resistance to PZA. Of 6 patients initially resistant to INH, RFP and PZA, 2 (33.3%) acquired additional resistance to EMB. Ten of the 41 MDR-TB patients (24.4%) changed from resistant to susceptible. No statistically significant risk factors associated with acquired resistance could be found.
CONCLUSION
First-line drugs should be used cautiously in the treatment of MDR-TB in Korea considering the potential acquisition of drug resistance.

Keyword

Tuberculosis; Multidrug resistance; Drug resistance

MeSH Terms

Drug Resistance
Drug Resistance, Multiple
Ethambutol
Hospitals, Chronic Disease
Humans
Isoniazid
Korea
Medical Records
Nitroimidazoles
Pyrazinamide
Retrospective Studies
Rifampin
Risk Factors
Sulfonamides
Tuberculosis
Tuberculosis, Multidrug-Resistant
Ethambutol
Isoniazid
Nitroimidazoles
Pyrazinamide
Rifampin
Sulfonamides
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