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Outcome of pulmonary multidrug-resistant tuberculosis: a 6-yr follow-up study.

Abstract
A retrospective study was performed to determine factors associated with the outcome of pulmonary multidrug-resistant tuberculosis (MDR-TB) in Taipei, Taiwan. All patients newly diagnosed with pulmonary MDR-TB in a referral centre from 1992-1996 were enrolled and their outcome over the subsequent 6 yrs was determined. A total of 299 patients were identified, comprising 215 (71.9%) males and 84 (28.1%) females with a mean age of 47.3 yrs. The patients received a mean of 3.7 effective drugs. Out of the 299 patients, 153 (51.2%) were cured, 31 (10.4%) failed, 28 (9.4%) died and 87 (29.1%) defaulted. Of the 125 patients receiving second-line drugs with ofloxacin, 74 (59.2%) were cured. Those who received ofloxacin had a lower risk of relapse than those receiving only first-line drugs (hazard ratio (HR) 0.16, 95% confidence interval (CI) 0.03-0.81) and a lower risk of TB-related death than those receiving second-line drugs but not ofloxacin (adjusted HR 0.50, 95% CI 0.31-0.82). In conclusion, multidrug-resistant tuberculosis patients who received ofloxacin were more likely to be cured, and were less likely to die, fail or relapse. The utility of new-generation fluoroquinolones, such as moxifloxacin, in the treatment of multidrug-resistant tuberculosis needs to be evaluated. Default from treatment is a major challenge in the treatment of multidrug-resistant tuberculosis.
AuthorsC-Y Chiang, D A Enarson, M-C Yu, K-J Bai, R-M Huang, C-J Hsu, J Suo, T-P Lin
JournalThe European respiratory journal (Eur Respir J) Vol. 28 Issue 5 Pg. 980-5 (Nov 2006) ISSN: 0903-1936 [Print] England
PMID16837502 (Publication Type: Journal Article)
Chemical References
  • Anti-Bacterial Agents
  • Antitubercular Agents
  • Ofloxacin
Topics
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents (pharmacology)
  • Antitubercular Agents (pharmacology)
  • Drug Resistance, Multiple, Bacterial (drug effects)
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis (drug effects)
  • Ofloxacin (pharmacology)
  • Recurrence
  • Retrospective Studies
  • Taiwan
  • Tuberculosis, Pulmonary (drug therapy, mortality)

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