Revised Category II regimen as an alternative strategy for retreatment of Category I regimen failure and irregular treatment cases.

摘要: Currently, the Category (CAT) II regimen is recommended for patients who have failed CAT I regimen. We determined before that prevalence of multidrug-resistant tuberculosis (MDR TB) relatively high among these patients. On other hand, retreatment success rate with in treatment failures and defaults nearly 50%. Therefore, we tried to find another strategy a higher rate. From January 2004 November 2007, 105 pulmonary TB, prior or more than one course irregular anti-TB treatment, were included this study, whereas five cases nontuberculous mycobacteria excluded. Drug susceptibility testing (DST), first line drugs, polymerase chain reaction performed. By time availability DST took 3 4 months, pilot protocol consisted isoniazid, rifampin, ethambutol, ofloxacin, cycloserine, amikacin was started. Then therapeutic adjusted based on four categories pattern: sensitive, non-MDR pattern, MDR culture-negative. Sensitive received standard regimen, an individualized DST, second-line culture-negatives plus 6-month injectable agent. Treatment outcomes categorized analyzed. Forty-eight failure 52 courses analysis. Six percent subjects had confirmed HIV infection. Seventy-two assigned good outcome 28% poor group. Seventeen Regarding 13% isolated strains completely sensitive first-line drugs. 53% MDR, 10% monodrug-resistant, 7% polydrug-resistant. There no significant association between pattern (P = 0.13). The associated TB as twice (69.2% versus 35.4%, P 0.004). Patients significantly experienced side effects non-MDR-TBs (47% 27%, 0.102). Of 100 patients, 72% cured, 5% abandoned 12% died, 6% classified failures, 1% relapsed, transferred out. 53 33 cured seven died. All together, successful achieved 62.2%, 76%, 76% cases, respectively. A replacing intermediate called revised may improve clinical found active, infectious TB. This reduces delays diagnosis initiation therapy. Success 62.2% overall defaulters,