Fluroquinolone drug resistance among MDR-TB patients increases the risk of unfavorable interim microbiological treatment outcome: An observational study
Abstract
BACKGROUND
Sputum culture conversion at the end of intensive phase of multi-drug resistant tuberculosis (MDR-TB) treatment is a key predictor for successful treatment outcome. This observational study was undertaken to assess the interim microbiological outcome of a cohort of rifampicin-resistant (RR)-TB patients with variable resistance to second-line drugs.
METHODS
During Jan-Apr 2018, we consecutively enrolled 100 RR-TB cases who underwent phenotypic drug susceptibility testing (DST) to assess the baseline resistance to second-line drugs. Following RR-TB diagnosis, these patients were started on MDR-TB treatment. At 6 months of treatment, sputum culture conversion status was determined. Data was analyzed to assess the impact of second line drugs resistance on culture conversion.
RESULTS
DST of total 100 RR-TB patients showed a high resistance to fluoroquinolone (FQs; levofloxacin-56%; moxifloxacin-44%) followed by kanamycin (8%) and capreomycin (6%). None of them were resistant to other drugs (amikacin, clofazimine and linezolid) tested. At 6 months of treatment follow-up, 28 patients were lost to follow-up and 8 died. Microbiological outcome could be obtained from the remaining 64 patients. Successful culture conversion was achieved in only 62.5% of patients. FQ-resistance was found to be a strong predictor (p < 0.001) for unfavorable microbiological outcome.
CONCLUSION
The rate of FQ-resistance among RR/MDR-TB is high and it has strong association with un-successful…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 64 participants or records.
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