Outcome of standardized treatment for patients with MDR-TB from Tamil Nadu, India
Programmatic management of MDR-TB using a standardized treatment regimen (STR) is being implemented under the Revised National Tuberculosis Control Programme (RNTCP) in India. This study was undertaken to analyse the outcomes of MDR-TB patients treated at the Tuberculosis Research Centre, Chennai, w...
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| Veröffentlicht in: | Indian journal of medical research (New Delhi, India : 1994) India : 1994), 2011-05, Vol.133 (5), p.529-534 |
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| creator | Joseph, Pauline Desai, Vijaya Bhaskara Rao Mohan, Nalini Sunder Fredrick, Jemima Sheila Ramachandran, Rajeswari Raman, Balambal Wares, Fraser Ramachandran, Ranjani Thomas, Aleyamma |
| description | Programmatic management of MDR-TB using a standardized treatment regimen (STR) is being implemented under the Revised National Tuberculosis Control Programme (RNTCP) in India. This study was undertaken to analyse the outcomes of MDR-TB patients treated at the Tuberculosis Research Centre, Chennai, with the RNTCP recommended 24 months STR, under programmatic conditions.
Patients failed to the category II re-treatment regimen and confirmed to have MDR-TB, were treated with the RNTCP's STR in a prospective field trial on a predominantly ambulatory basis. Thirty eight patients were enrolled to the trial from June 2006 to September 2007.
Time to culture conversion was two months or less for 82 per cent of patients. Culture conversion rates at 3 and 6 months were 84 and 87 per cent respectively. At the end of treatment, 25 (66%) were cured, 5 defaulted, 3 died and 5 failed. At 24 months, 30 (79%) patients, including 5 defaulters, remained culture negative for more than 18 months. Twenty two (58%) patients reported adverse drug reactions (ADRs) which required dose reduction or termination of the offending drug. No patient had XDR-TB initially, but 2 failure cases emerged as XDR-TB during treatment.
Outcomes of this small group of MDR-TB patients treated with the RNTCP's STR is encouraging in this setting. Close attention needs to be paid to ensure adherence, and to the timely recognition and treatment of ADRs. |
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Patients failed to the category II re-treatment regimen and confirmed to have MDR-TB, were treated with the RNTCP's STR in a prospective field trial on a predominantly ambulatory basis. Thirty eight patients were enrolled to the trial from June 2006 to September 2007.
Time to culture conversion was two months or less for 82 per cent of patients. Culture conversion rates at 3 and 6 months were 84 and 87 per cent respectively. At the end of treatment, 25 (66%) were cured, 5 defaulted, 3 died and 5 failed. At 24 months, 30 (79%) patients, including 5 defaulters, remained culture negative for more than 18 months. Twenty two (58%) patients reported adverse drug reactions (ADRs) which required dose reduction or termination of the offending drug. No patient had XDR-TB initially, but 2 failure cases emerged as XDR-TB during treatment.
Outcomes of this small group of MDR-TB patients treated with the RNTCP's STR is encouraging in this setting. Close attention needs to be paid to ensure adherence, and to the timely recognition and treatment of ADRs.</description><identifier>ISSN: 0971-5916</identifier><identifier>PMID: 21623039</identifier><language>eng</language><publisher>India: Medknow Publications and Media Pvt. Ltd</publisher><subject>Adult ; Adverse and side effects ; Antibiotics, Antitubercular - therapeutic use ; Care and treatment ; Communicable Disease Control - methods ; Communicable Disease Control - statistics & numerical data ; Cycloserine - therapeutic use ; Directly Observed Therapy ; Drug resistance in microorganisms ; Drug therapy ; Drug-Related Side Effects and Adverse Reactions - pathology ; Drugs ; Ethambutol - therapeutic use ; Ethionamide - therapeutic use ; Female ; Humans ; India ; Kanamycin - therapeutic use ; Male ; Middle Aged ; Ofloxacin - therapeutic use ; Original ; Patient outcomes ; Prospective Studies ; Pyrazinamide - therapeutic use ; Sputum - microbiology ; Time Factors ; Treatment Outcome ; Tuberculosis ; Tuberculosis, Multidrug-Resistant - drug therapy</subject><ispartof>Indian journal of medical research (New Delhi, India : 1994), 2011-05, Vol.133 (5), p.529-534</ispartof><rights>COPYRIGHT 2011 Medknow Publications and Media Pvt. Ltd.</rights><rights>The Indian Journal of Medical Research 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121285/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121285/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21623039$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Joseph, Pauline</creatorcontrib><creatorcontrib>Desai, Vijaya Bhaskara Rao</creatorcontrib><creatorcontrib>Mohan, Nalini Sunder</creatorcontrib><creatorcontrib>Fredrick, Jemima Sheila</creatorcontrib><creatorcontrib>Ramachandran, Rajeswari</creatorcontrib><creatorcontrib>Raman, Balambal</creatorcontrib><creatorcontrib>Wares, Fraser</creatorcontrib><creatorcontrib>Ramachandran, Ranjani</creatorcontrib><creatorcontrib>Thomas, Aleyamma</creatorcontrib><title>Outcome of standardized treatment for patients with MDR-TB from Tamil Nadu, India</title><title>Indian journal of medical research (New Delhi, India : 1994)</title><addtitle>Indian J Med Res</addtitle><description>Programmatic management of MDR-TB using a standardized treatment regimen (STR) is being implemented under the Revised National Tuberculosis Control Programme (RNTCP) in India. This study was undertaken to analyse the outcomes of MDR-TB patients treated at the Tuberculosis Research Centre, Chennai, with the RNTCP recommended 24 months STR, under programmatic conditions.
Patients failed to the category II re-treatment regimen and confirmed to have MDR-TB, were treated with the RNTCP's STR in a prospective field trial on a predominantly ambulatory basis. Thirty eight patients were enrolled to the trial from June 2006 to September 2007.
Time to culture conversion was two months or less for 82 per cent of patients. Culture conversion rates at 3 and 6 months were 84 and 87 per cent respectively. At the end of treatment, 25 (66%) were cured, 5 defaulted, 3 died and 5 failed. At 24 months, 30 (79%) patients, including 5 defaulters, remained culture negative for more than 18 months. Twenty two (58%) patients reported adverse drug reactions (ADRs) which required dose reduction or termination of the offending drug. No patient had XDR-TB initially, but 2 failure cases emerged as XDR-TB during treatment.
Outcomes of this small group of MDR-TB patients treated with the RNTCP's STR is encouraging in this setting. Close attention needs to be paid to ensure adherence, and to the timely recognition and treatment of ADRs.</description><subject>Adult</subject><subject>Adverse and side effects</subject><subject>Antibiotics, Antitubercular - therapeutic use</subject><subject>Care and treatment</subject><subject>Communicable Disease Control - methods</subject><subject>Communicable Disease Control - statistics & numerical data</subject><subject>Cycloserine - therapeutic use</subject><subject>Directly Observed Therapy</subject><subject>Drug resistance in microorganisms</subject><subject>Drug therapy</subject><subject>Drug-Related Side Effects and Adverse Reactions - pathology</subject><subject>Drugs</subject><subject>Ethambutol - therapeutic use</subject><subject>Ethionamide - therapeutic use</subject><subject>Female</subject><subject>Humans</subject><subject>India</subject><subject>Kanamycin - therapeutic use</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Ofloxacin - therapeutic use</subject><subject>Original</subject><subject>Patient outcomes</subject><subject>Prospective Studies</subject><subject>Pyrazinamide - therapeutic use</subject><subject>Sputum - microbiology</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Tuberculosis</subject><subject>Tuberculosis, Multidrug-Resistant - drug therapy</subject><issn>0971-5916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUd9LwzAQ7oPi5vRfkICvVpqkSZMXYc5fg-lQ5nO5tskWaZrRpor-9QamsoGI3MMdd999d9_dXjRMZIZjJjEfRIdd95IkWJJMHkQDgjmhCZXD6HHe-9JZhZxGnYemgrYyH6pCvlXgrWo80q5Fa_AmxB16M36F7q-e4sUl0q2zaAHW1OgBqv4MTZvKwFG0r6Hu1PGXH0XPN9eLyV08m99OJ-NZvKRS-pilmhVCEwWCspQpkqZSqIQoSngCGceSFpkoMJMacyE4ECgIy0ipCyBSAh1FFxvedV9YVZVhvRbqfN0aC-177sDku5XGrPKle80pJpgIFghONwRLqFVuGu0CrLSmK_Mx4RlmnCTp3ygmpEzDMQPq_BdUsEpZU7pGaRPyO7T_a9iacLIt90fn9yvpJzpWln0</recordid><startdate>201105</startdate><enddate>201105</enddate><creator>Joseph, Pauline</creator><creator>Desai, Vijaya Bhaskara Rao</creator><creator>Mohan, Nalini Sunder</creator><creator>Fredrick, Jemima Sheila</creator><creator>Ramachandran, Rajeswari</creator><creator>Raman, Balambal</creator><creator>Wares, Fraser</creator><creator>Ramachandran, Ranjani</creator><creator>Thomas, Aleyamma</creator><general>Medknow Publications and Media Pvt. Ltd</general><general>Medknow Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>5PM</scope></search><sort><creationdate>201105</creationdate><title>Outcome of standardized treatment for patients with MDR-TB from Tamil Nadu, India</title><author>Joseph, Pauline ; Desai, Vijaya Bhaskara Rao ; Mohan, Nalini Sunder ; Fredrick, Jemima Sheila ; Ramachandran, Rajeswari ; Raman, Balambal ; Wares, Fraser ; Ramachandran, Ranjani ; Thomas, Aleyamma</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-g399t-54f5b8f2ea83545e24498e02e3260a76193b78b159f16886a2ab2572cfba299a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Adverse and side effects</topic><topic>Antibiotics, Antitubercular - therapeutic use</topic><topic>Care and treatment</topic><topic>Communicable Disease Control - methods</topic><topic>Communicable Disease Control - statistics & numerical data</topic><topic>Cycloserine - therapeutic use</topic><topic>Directly Observed Therapy</topic><topic>Drug resistance in microorganisms</topic><topic>Drug therapy</topic><topic>Drug-Related Side Effects and Adverse Reactions - pathology</topic><topic>Drugs</topic><topic>Ethambutol - therapeutic use</topic><topic>Ethionamide - therapeutic use</topic><topic>Female</topic><topic>Humans</topic><topic>India</topic><topic>Kanamycin - therapeutic use</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Ofloxacin - therapeutic use</topic><topic>Original</topic><topic>Patient outcomes</topic><topic>Prospective Studies</topic><topic>Pyrazinamide - therapeutic use</topic><topic>Sputum - microbiology</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Tuberculosis</topic><topic>Tuberculosis, Multidrug-Resistant - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Joseph, Pauline</creatorcontrib><creatorcontrib>Desai, Vijaya Bhaskara Rao</creatorcontrib><creatorcontrib>Mohan, Nalini Sunder</creatorcontrib><creatorcontrib>Fredrick, Jemima Sheila</creatorcontrib><creatorcontrib>Ramachandran, Rajeswari</creatorcontrib><creatorcontrib>Raman, Balambal</creatorcontrib><creatorcontrib>Wares, Fraser</creatorcontrib><creatorcontrib>Ramachandran, Ranjani</creatorcontrib><creatorcontrib>Thomas, Aleyamma</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Indian journal of medical research (New Delhi, India : 1994)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Joseph, Pauline</au><au>Desai, Vijaya Bhaskara Rao</au><au>Mohan, Nalini Sunder</au><au>Fredrick, Jemima Sheila</au><au>Ramachandran, Rajeswari</au><au>Raman, Balambal</au><au>Wares, Fraser</au><au>Ramachandran, Ranjani</au><au>Thomas, Aleyamma</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcome of standardized treatment for patients with MDR-TB from Tamil Nadu, India</atitle><jtitle>Indian journal of medical research (New Delhi, India : 1994)</jtitle><addtitle>Indian J Med Res</addtitle><date>2011-05</date><risdate>2011</risdate><volume>133</volume><issue>5</issue><spage>529</spage><epage>534</epage><pages>529-534</pages><issn>0971-5916</issn><abstract>Programmatic management of MDR-TB using a standardized treatment regimen (STR) is being implemented under the Revised National Tuberculosis Control Programme (RNTCP) in India. This study was undertaken to analyse the outcomes of MDR-TB patients treated at the Tuberculosis Research Centre, Chennai, with the RNTCP recommended 24 months STR, under programmatic conditions.
Patients failed to the category II re-treatment regimen and confirmed to have MDR-TB, were treated with the RNTCP's STR in a prospective field trial on a predominantly ambulatory basis. Thirty eight patients were enrolled to the trial from June 2006 to September 2007.
Time to culture conversion was two months or less for 82 per cent of patients. Culture conversion rates at 3 and 6 months were 84 and 87 per cent respectively. At the end of treatment, 25 (66%) were cured, 5 defaulted, 3 died and 5 failed. At 24 months, 30 (79%) patients, including 5 defaulters, remained culture negative for more than 18 months. Twenty two (58%) patients reported adverse drug reactions (ADRs) which required dose reduction or termination of the offending drug. No patient had XDR-TB initially, but 2 failure cases emerged as XDR-TB during treatment.
Outcomes of this small group of MDR-TB patients treated with the RNTCP's STR is encouraging in this setting. Close attention needs to be paid to ensure adherence, and to the timely recognition and treatment of ADRs.</abstract><cop>India</cop><pub>Medknow Publications and Media Pvt. Ltd</pub><pmid>21623039</pmid><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Indian journal of medical research (New Delhi, India : 1994), 2011-05, Vol.133 (5), p.529-534 |
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| source | MEDLINE; PubMed Central Open Access; PubMed Central |
| subjects | Adult Adverse and side effects Antibiotics, Antitubercular - therapeutic use Care and treatment Communicable Disease Control - methods Communicable Disease Control - statistics & numerical data Cycloserine - therapeutic use Directly Observed Therapy Drug resistance in microorganisms Drug therapy Drug-Related Side Effects and Adverse Reactions - pathology Drugs Ethambutol - therapeutic use Ethionamide - therapeutic use Female Humans India Kanamycin - therapeutic use Male Middle Aged Ofloxacin - therapeutic use Original Patient outcomes Prospective Studies Pyrazinamide - therapeutic use Sputum - microbiology Time Factors Treatment Outcome Tuberculosis Tuberculosis, Multidrug-Resistant - drug therapy |
| title | Outcome of standardized treatment for patients with MDR-TB from Tamil Nadu, India |
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