바로가기메뉴

본문 바로가기 주메뉴 바로가기

Treatment of Isoniazid-Resistant Pulmonary Tuberculosis

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2004, v.56 no.3, pp.248-260











  • Downloaded
  • Viewed

Abstract

Background:As an effective regimen for isoniazid (INH)-resistant pulmonary tuberculosis, several treatment regimens have been recommended by many experts. In Korea, a standard regimen has not been established for INH-resistant tuberculosis, and the treatment by individual physicians has been performed on an empirical bases. The purpose of the present study was to retrospectively describe the treatment characteristics and evaluate the treatment outcomes of patients with INH-resistant tuberculosis.Materials and Methods:Sixty of 69 patients reported to have INH-resistant tuberculosis from 1994 to 2001 were retrospectively analyzed. Exclusion criteria included: death from other causes, with the exceptions of tuberculosis and incomplete treatment, including a patient's transfer-out.Results:A previous tuberculosis history was found in 28 (46.7%) patients. The sputum smear for acid-fast bacilli was positive in 44 (73.3%) patients, and 30 (50.0%) had cavitary disease. Streptomycin resistance coexisted in 25.0% of isolates. INH was to be prescribed continuously, even after INH resistance was reported, in 86.0% of patients. The treatment regimens were diverse between the patients according to drug regimen composition and treatment duration. The most frequent prescribed regimen included rifampin, ethambutol and pyrazinamide, with and without INH, for the full 12-month term of treatment. Treatment failure occurred in 13 (21.7%) patients. Cavitary disease (p=0.005) and a treatment regimen with second-line drugs, excluding rifampin (p=0.015), were associated with treatment failure. One patient experienced a relapse.Conclusions:Standardized treatment guidelines will be needed in Korea to improve the treatment efficacy for INH-resistant tuberculosis.(Tuberculosis and Respiratory Diseases 2004, 56:248-260)

keywords
Pulmonary tuberculosis, Drug resistance, Isoniazid, Treatment, Pulmonary tuberculosis, Drug resistance, Isoniazid, Treatment

Reference

1.

(1997) 우리 나라 결핵어제, 오늘, 내일. 결핵 및 호흡기질환 ,

2.

(2003) The treatment of tuberculosis in South Korea,

3.

(2001) Global trends in resistance to antituberculosis drugs. World Health Organization-International Uniꠀon against Tuberculosis and Lung Disease Working Group on Anti-Tuberculosis Drug Resistance Surveillance,

4.

(1994) Treatment of tuberculosis and tuberculosis infection in adults and children,

5.

(2003) American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America. Treatment of tuberculosis,

6.

(1998) Chemotherapy and management of tuberculosis in the United Kingdom:recommendations 1998,

7.

(1997) 폐결핵 진료의 기준,1997,

8.

(2002) 2002년 결핵관리지침, 국립보건원

9.

(2003) 한 민간종합병원에서 진단된 폐결핵 환자의 약제내성 실태조사. 결핵 및 호흡기질환,

10.

(2000) Diagnostic standards and classification of tuberculosis in adults and children,

11.

(1997) Drug-resistant tuberculosis in Korea,1994,

12.

(2001) International Union Against Tuberculosis and Lung Disease, Royal Netherlands Tuberculosis Association. Revised international definitions in tuberculosis control,

13.

(2003) Treatment of tuberculosis: guidelines for national programmes, World Health Organization

14.

(1997) Guidelines for the management of drug-resistant tuberculosis, World Health Organization

15.

(2000) Standard short-course chemotherapy for drug-resistant tuberculosis: treatment outcomes in 6 countries,

16.

(amrevrespirdis1981) Should isoniazid be used in retreatment of tuberculosis despite acquired isoniazid resistance,

17.

(2004) Chapter 48. Management of multidrug-resistant tuberculosis. In:Tuberculosis, Lippincott Williams & Wilkins

18.

(1986) Influence of initial drug resistance on the response to short- course chemotherapy of pulmonary tuberꠀculosis,

19.

(1999) Studies on the treatment of tuberculosis undertaken by the British Medical Research Council tuberculosis units, 1946-1986, with relevant subsequent publications,

20.

(amrevrespirdis1979) Clinical trial of six- month and four-month regimens of chemoꠀ therapy in the treatment of pulmonary tuberꠀ,

21.

(1981) Controlled trial of four thrice-weekly regimens and a daily regimen all given for 6 months for pulmonary tuberꠀculosis,

22.

(1987) Five-year follow-up of a controlled trial of five 6-month regimens of chemotherapy for pulmonary tuberculosis,

23.

(2002) Treatment of isoniazid-resistant tuberculosis with isoniazid and pyrazinamide for 6 months,

24.

(2001) Treatment of isoniazid-resistant tuberculosis in southeastern Texas,

25.

(1993) The resurgence of tuberculosis: is your laboratory ready?,

26.

(1999) 국내 3차 및 대학병원에서의 결핵균 검사 실태조사,

27.

(2001) 국내 결핵균 검사 기관의 결핵균 검사 실태의 변화,

28.

(1997) 우리나라 결핵균 검사의 현재와 미래 어디까지 해야하나,

29.

(1997) 우리나라 결핵균 검사의 현재와 미래 임상의의 기대,

30.

(1988) Controlled clinical trial of a regimen of two durations for the treatment of isoniazid resistant tuberculosis,

31.

(2001) Can a nine-month regimen be used to treat isoniꠀ azid resistant tuberculosis diagnosed after standard treatment is started,

32.

(2003) 한 민간종합병원에서 진단된 폐결핵 환자의 특성과 치료성적,

33.

(1999) 한국인 결핵환자에서 Isoniazid와 Rifampicin의 약동학,

34.

(1998) Low serum antimycobacterial drug levels in non-HIV- infected tuberculosis patients,

35.

(2001) Utility of rifampin blood levels in the treatment and follow-up of active pulmonary tuberculosis in patients who were slow to respond to routine directly observed therapy,

36.

(1995) Multidrug-resistant tuberculosis in patients without HIV infection,

37.

(1998) Outcome of chemotherapy in 107 patients with pulmonary tuberculosis resistant to isoniazid and rifampin,

38.

(2000) Outcomes of patients with multidrug-resistant pulmonary tuberculosis treated with ofloxacin/levofloꠀxacin-containing regimens,

Tuberculosis & Respiratory Diseases