Drug - Resistant Pulmonary Tuberculosis in a Tertiary Referral Hospital in Korea

Objectives : To estimate the resistance rate and to correlate the clinical characteristics of resistant tuberculosis with the patients of pulmonary tuberculosis who were referred to the university hospital. Methods : We prospectively performed sensitivity tests for all patients who were diagnosed as...

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Bibliographic Details
Published in:The Korean journal of internal medicine 1999-01, Vol.14 (1), p.27
Main Authors: Sun Young Kim, Seong Su Jeong, Keun Wha Kim, Kyoung Sang Shin, Sang Gee Park, Ae Kyoung Kim, Hai Jeong Cho, Ju Ock Kim
Format: Article
Language:Korean
Subjects:
drug - resistance
sensitivity test
treatment failure
tuberculosis
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Summary:Objectives : To estimate the resistance rate and to correlate the clinical characteristics of resistant tuberculosis with the patients of pulmonary tuberculosis who were referred to the university hospital. Methods : We prospectively performed sensitivity tests for all patients who were diagnosed as active tuberculosis by sputum smear or sputum culture from January, 1995 to June, 1996. Patients profile, previous treatment history, patterns of drug resistance, initial chest films and other clinical findings were analysed. Results : Overall, 24(26.0%) of the 92 patients had resistance to at least one drug and 8(8.6%) had resistance to isoniazid(INH) and rifampin(RFP). Among the 66 patients without previous tuberculosis therapy, 11(16.6%) were drug-resistant and 2(3.0%) were multi-drug resistant. Among the 26 patients with previous therapy , 13(50.0%) were drug-resistant and 6(23.0%) were multi-drug resistant. For all 92, resistance to INH was most common(19.5%), followed by RFP(9.7%) and ethambutol(9.7%). Drug resistance was significantly high in previously treated patients and in cavity-positive patients. Treatment failure was also high in previously treated patients with resistant tuberculosis. In patients with primary resistance, treatment failure was not observed. Conclusion : Sensitivity tests are strongly recommended in all culture positive patients with previous therapy but, in patients with primary resistance, sensitivity tests are not required. Proper combination chemotherapy should be given under careful surveillance.
ISSN:1226-3303
2005-6648