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http://dx.doi.org/10.4046/trd.2009.66.3.198

Acquired Drug Resistance during Standardized Treatment with First-line Drugs in Patients with Multidrug-Resistant Tuberculosis  

Jeon, Doosoo (National Masan Tuberculosis Hospital)
Kim, Dohyung (National Masan Tuberculosis Hospital)
Kang, Hyungseok (National Masan Tuberculosis Hospital)
Min, Jinhong (National Masan Tuberculosis Hospital)
Sung, Nackmoon (National Masan Tuberculosis Hospital)
Hwang, Soohee (National Masan Tuberculosis Hospital)
Park, Seungkew (National Masan Tuberculosis Hospital)
Publication Information
Tuberculosis and Respiratory Diseases / v.66, no.3, 2009 , pp. 198-204 More about this Journal
Abstract
Background: First-line drugs, if sensitive, are the most potent drugs in the treatment of multidrug-resistant tuberculosis (MDR-TB). This study examined the frequency and risk factors associated with acquired drug resistance to first-line drugs during a standardized treatment using first-line drugs in patients with MDR-TB. Methods: This study included patients who were diagnosed with MDR-TB at the National Masan Tuberculosis Hospital between January 2004 and May 2008, treated with standardized first-line drugs, and for whom the preand post-treatment results of the drug susceptibility test were available. Their medical records were reviewed retrospectively. Results: Of 41 MDR-TB patients, 14 (34.1%) acquired additional resistance to ethambutol (EMB) or pyrazinamide (PZA). Of 11 patients initially resistant to isoniazid (INH) and rifampicin (RFP), 3 (27.3%) acquired additional resistance to both EMB and PZA, and 3 (27.3%) to PZA. Of 18 patients initially resistant to INH, RFP and EMB, 6 (33.3%) acquired additional resistance to PZA. Of 6 patients initially resistant to INH, RFP and PZA, 2 (33.3%) acquired additional resistance to EMB. Ten of the 41 MDR-TB patients (24.4%) changed from resistant to susceptible. No statistically significant risk factors associated with acquired resistance could be found. Conclusion: First-line drugs should be used cautiously in the treatment of MDR-TB in Korea considering the potential acquisition of drug resistance.
Keywords
Tuberculosis; Multidrug resistance; Drug resistance;
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