Document Detail


Treatment of isoniazid-resistant tuberculosis in southeastern Texas.
MedLine Citation:
PMID:  11399698     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Chest     Volume:  119     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-06-11     Completed Date:  2001-07-12     Revised Date:  2014-07-28    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1730-6     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
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*
Grant Support
ID/Acronym/Agency:
DA-09238/DA/NIDA NIH HHS
Chemical
Reg. No./Substance:
0/Antitubercular Agents; V83O1VOZ8L/Isoniazid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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