연구배경:치료 경력이 있는 환자의 약제 내성은 진료의사의 처방의 적절성 및 환자의 복용 순응도를 복합적으로 나타내어 주는 지표가 될 수 있으므로, 우리나라에서 재치료 대상 결핵 환자에서 장기간의 약제내성률 추이를 파악하고자 하였다.방법:연도별 보건소 등록환자의 약제감수성 검사 결과 및 결핵연구원의 전산 입력된 자료를 활용하여 1981년부터 2004년 사이에 주요 약제에 대한 내성률의 변화를 분석하였다.
Background : The drug resistance rate in tuberculosis patients with history of chemotherapy is an important indicator of for evaluation of appropriateness of treatment regimens and compliance of patients. This study examined the long-term changes in the drug resistance rates among TB patients failed in treatment or reactivated. Methods : The results of drug susceptibility testing data from patients registered in health centers from 1981 to 2004 were analyzed. Results : The rate of resistance to isoniazid decreased from 90% to 20%, and the resistance to ethambutol decreased from 45% to 6%. The rate of resistance to rifampicin varied from 13% to 28% and the resistance to pyrazinamide was 5% to 10%. Multidrug resistance was about 2-3% lower than any rifampicin resistance rates. The second-line drug resistance was ranged from 1% to 3%. There was no difference between patients' genders. Patient numbers per 100,000 population increased with age. The regional distribution was even at 4-6 patients per 100,000 population, and drug resistance rates were significantly lower in big city areas than in small towns and rural areas. Conclusion : The rates of resistance of Mycobacterium tuberculosis isolated from TB patients with history of chemotherapy to isoniazid, rifampin, ethambutol, and isoniazid plus rifampin were significantly decreased during over two decades. (Tuberc Respir Dis 2005; 59: 619-624)
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