Tuberc Respir Dis.  2007 Nov;63(5):417-422. 10.4046/trd.2007.63.5.417.

Clinical Manifestations of Persistent Smear Positive and Culture Negative Sputum Tests 5 Months after First-line Anti-Tuberculous Chemotherapy

• Kim DH
• Hwang SH
• Cheon DS
• Min JH
• Kang HS
• Park SG

• KMID: 2050474
• DOI: http://doi.org/10.4046/trd.2007.63.5.417

Abstract

BACKGROUND: It is not known with certainty whether patients with persistently positive sputum smear results who have also had negative sputum culture results require prolongation of treatment for tuberculosis in order to avoid an increased risk of eventual relapse. The purpose of the present study was to retrospectively describe the treatment characteristics and evaluate the appropriate duration of treatment in these patients.
METHODS
Sixty of 69 patients with sputum smear positive and culture negative tests at 5 months after first line anti-tuberculous chemotherapy from 2002 to 2003 were retrospectively analyzed. Exclusion criteria included incomplete treatment or resistance to rifampicin or two additional antibiotics, as determined by a drug susceptibility test (DST).
RESULTS
Smear conversion of the study subjects was observed after 8.3+/-2.3 months treatment, and the patients were culture negative after 2.0+/-0.8 months. The relapse rates of the study subjects were 3.8, 10.0, and 25.8% after 1, 2, and 5 years of anti-tuberculosis chemotherapy, respectively. The relapse rates were not significantly affected by a series of risk factors such as age, sex, presence of diabetes, a sputum culture examination after 2 months treatment, previous treatment history, chest radiograph, and duration of the treatment (p>0.05).
CONCLUSION
Regimen change is not required for patients with persistent smear positive but culture negative tests in the fifth month for first line antituberculous treatment. However, a further study will be needed to clarify the high relapse rate in this specific group of patients.

Keyword

Pulmonary tuberculosis; Acid-fast bacilli; Relapse

MeSH Terms

Anti-Bacterial Agents
Drug Therapy*
Humans
Radiography, Thoracic
Recurrence
Retrospective Studies
Rifampin
Risk Factors
Sputum*
Tuberculosis
Tuberculosis, Pulmonary
Anti-Bacterial Agents
Rifampin

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