학술논문

Treatment outcomes for isoniazid-resistant tuberculosis under program conditions in British Columbia, Canada.
Document Type
Journal Article
Source
BMC Infectious Diseases. 9/4/2017, Vol. 17, p1-7. 7p. 1 Diagram, 3 Charts, 1 Graph.
Subject
*TUBERCULOSIS treatment
*ISONIAZID
*DRUG resistance
*TREATMENT effectiveness
*DRUG therapy for tuberculosis
*TUBERCULOSIS microbiology
*ANTITUBERCULAR agents
*TUBERCULOSIS epidemiology
*QUINOLONE antibacterial agents
*DRUG resistance in microorganisms
*MICROBIAL sensitivity tests
*MYCOBACTERIUM tuberculosis
*DISEASE relapse
*RETROSPECTIVE studies
*THERAPEUTICS
Language
ISSN
1471-2334
Abstract
Background: Every year, over 1 million people develop isoniazid (INH) resistant tuberculosis (TB). Yet, the optimal treatment regimen remains unclear. Given increasing prevalence, the clinical efficacy of regimens used by physicians is of interest. This study aims to examine treatment outcomes of INH resistant TB patients, treated under programmatic conditions in British Columbia, Canada.Methods: Medical charts were retrospectively reviewed for cases of culture-confirmed INH mono-resistant TB reported to the BC Centre for Disease Control (BCCDC) from 2002 to 2014. Treatment regimens, patient and strain characteristics, and clinical outcomes were analysed.Results: One hundred sixty five cases of INH mono-resistant TB were included in analysis and over 30 different treatment regimens were prescribed. Median treatment duration was 10.5 months (IQR 9-12 months) and treatment was extended beyond 12 months for 26 patients (15.8%). Fifty six patients (22.6%) experienced an adverse event that resulted in a drug regimen modification. Overall, 140 patients (84.8%) had a successful treatment outcome while 12 (7.2%) had an unsuccessful treatment outcome of failure (n = 2; 1.2%), relapse (n = 4; 2.4%) or all cause mortality (n = 6; 3.6%).Conclusion: Our treatment outcomes, while consistent with findings reported from other studies in high resource settings, raise concerns about current recommendations for INH resistant TB treatment. Only a small proportion of patients completed the recommended treatment regimens. High quality studies to confirm the effectiveness of standardized regimens are urgently needed, with special consideration given to trials utilizing fluoroquinolones. [ABSTRACT FROM AUTHOR]