| Abstract | BACKGROUND: Isoniazid-resistant tuberculosis (INHr-TB) can be treated successfully with several treatment regimens. However, the optimal regimen and duration are unclear. Study objective: To analyze the efficacy of treatment regimens used for INHr-TB in the southeastern Texas region. DESIGN: Retrospective cohort study. SETTING: Health-care facilities reporting tuberculosis (TB) patients in the Houston and Tyler areas. SUBJECTS: All patients reported to have INHr-TB from 1991 to 1998. Exclusion criteria included poor compliance, additional first-line drug-resistance (except aminoglycosides), and death before completion of 1 month of treatment. MEASUREMENTS AND RESULTS: Main treatment outcomes were treatment failure, relapse, and TB-related death. Fifty-three of 83 patients were included in the study; aminoglycoside resistance coexisted in 37.5% of isolates. Seven types of treatment regimens were identified. Eighteen patients (34%) received rifampin, pyrazinamide, and ethambutol thrice weekly for 9 months. Four patients (7.5%) had a total effective treatment duration of < 9 months. Thirty patients (56.6%) and 16 patients (30.2%) received thrice-daily and daily treatment regimens, respectively. Forty-nine patients achieved sputum conversion. Treatment failure and death occurred in one patient (1.9%). Three patients (5.7%) experienced relapses. There was a significant difference in total effective treatment time between patients with and without relapses (8.3 +/- 1.1 months vs 11.1 +/- 2.1 months; p < 0.02). Twice-weekly treatment regimens were associated with relapse (p = 0.05). CONCLUSIONS: Several treatment regimens were prescribed for INHr-TB in southeastern Texas. INHr-TB treatment durations were > 7 months, and treatment regimen efficacy was adequate. Twice-weekly treatment was associated with relapse, whereas thrice-weekly and daily treatments performed similarly. A prospective study with different treatment durations is needed to determine the optimal treatment regimen for patients with INHr-TB. |
| Authors | P Escalante, E A Graviss, D E Griffith, J M Musser, R J Awe
(Affiliation: Sections of Pulmonary and Critical Care, Institute for the Study of Human Bacterial Pathogenesis, Baylor College of Medicine, Houston, TX, USA. Patricioe at aol.com)
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| Journal | Chest
(Chest)
Vol. 119
Issue 6
Pg. 1730-6
(Jun 2001)
ISSN: 0012-3692 United States |
| PMID | 11399698
(Publication Type: Clinical Trial, Journal Article, Research Support, U.S. Gov't, P.H.S.)
|
| Chemical References |
- Antitubercular Agents
- Isoniazid
|
| Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antitubercular Agents
(administration & dosage)
- Child
- Child, Preschool
- Cohort Studies
- Drug Administration Schedule
- Drug Resistance, Microbial
- Female
- Humans
- Infant
- Isoniazid
(pharmacology)
- Male
- Middle Aged
- Retrospective Studies
- Texas
- Treatment Outcome
- Tuberculosis, Pulmonary
(drug therapy)
|
