PURPOSE: We carried out this study to determine the efficacy and safety of a regimen containing Kanamycin, Ethionamide, PAS and Cycloserine in Multi-drug resistant pulmonary tuberculosis patients.
METHODS: A prospective, uncontrolled study of 45 pulmonary tuberculosis patients, who had received adequate first-line anti-tuberculosis treatment including supervised category II retreatment regimen, and were still sputum smear positive for acid fast bacill and resistant to at least Isoniazide and Rifampicin. They were planed to give Kanamycin (initial 4-6 months), Ethionamide, PAS and Cycloserine for a minimum period of two years.
RESULTS: Out of 45 patients, 35 (77.7%) achieved sputum conversion with in 6 months and 34 (75.5%) remained so at the end of two years. 2 (4.4%) patients expired, 6 (13.3%) patients were lost to follow up, and 3 (6.6%) patients remained sputum smear positive for AFB through out the period of study. 34 patients, declared cured, were followed for an average period of 17.4 months (3-60 months), during which 2 (5.7%) patients relapsed, 6 (17.6%) patients were lost to follow-up and rest 26 (76.4%) remained sputum smear for AFB negative. 8 (17.7%) patients developed major side effects which required stoppage/change of drugs.
CONCLUSION: In MDR-TB patients, regimen consisting of Ethionomide, PAS and Cycloserine with injection Kanamycin in initial 4-6 months appears to be effective and safe.
CLINICAL IMPLICATIONS: MDR TB can be cured successfully with appropriate combination of drugs for an adequate duration and require-s-much effort from both the patients and health care workers.
DISCLOSURE: Rajendra Prasad, None.
Rajendra Prasad MD * S.K. Verma MD A. Jain MD King George Medical University, Lucknow, India
COPYRIGHT 2005 American College of Chest Physicians
COPYRIGHT 2005 Gale Group