EFFICACY OF DRUGS IN DRUG-RESISTANT TUBERCULOSIS: A RETROSPECTIVE OBSERVATIONAL STUDYAbstract
Introduction: Drug-resistant tuberculosis (DR-TB) emerged from the time anti-tuberculosis drugs were discovered and used. It has become a formidable obstacle in the eradication of tuberculosis. India is in second position after China with tuberculosis, where about 20% of patients with DR-TB were not treated due to inappropriate coordination and diagnostic facilities. Method and Materials: A retrospective observational study aimed to assess various resistance patterns, distribution among genders, and efficacy of DR-TB regimen (2016-2019). Institutional ethical clearance with approval from the state and district TB center were obtained, and a structured data collection form was created to collect patient details registered under Ernakulam district TB unit, Kerala, India. Data obtained were statistically analyzed with Mantel-Cox test using SPSS version 25. Results and Discussion: Study shows that rifampicin resistant tuberculosis (RR-TB) is most common form of DR-TB in newly diagnosed patients. In previously treated patients, both Multidrug Resistance and RR-TB were recorded as 38%. Rifampicin and isoniazid were drugs with high resistance and on comparing the efficacy, shorter regimen had higher efficacy than conventional regimen. High failure and death rates were observed with conventional regimen. Survival analysis showed a higher survival rate with shorter regimen. Conclusion: Resistance emergence was a very frequent obstacle to overcome with the existing established sensitive drug therapy against tuberculosis. The causes and factors remain unclear, but solution lies in innovative diagnostic approaches and individualized selection of drug regimens. Resistance, if continued to be unnoticed, could lead to a shortage of effective existing drugs, prompting the development of newer drugs.
Joicy Jose, Leya P. Babu, Nimmy Robin, Johnson V. Babu and Shaji George *
Department of Pharmacy Practice, Nirmala College of Pharmacy, Muvattupuzha, Kerala, India.
27 December 2020
19 May 2021
26 May 2021
01 November 2021