Investigating the Effectiveness of Long-term Regimen versus Short-term Regimen in Treating Drug Resistant Tuberculosis and their Treatment Outcomes
Keywords:
Tuberculosis, Treatment Outcome, LTR, STR, MDR-TBAbstract
Background Drug-resistant tuberculosis, defined by resistance to conventional antitubercular medications, presents significant treatment challenges. The efficacy of long-term versus short-term treatment regimens in managing this condition remains a critical area of investigation. Objective To assess how different treatment durations, both long-term and short-term regimen, influence the rates of treatment success, treatment failure, and mortality among patients suffering from drug-resistant tuberculosis. Methodology This prospective cohort study was conducted from June 2021 to December 2023 in the Department of pulmonology, Mardan Medical Complex, Khyber Pakhtunkhwa, Pakistan. In this study DR-TB patients were enrolled. Patients were randomly assigned to long-term or short-term regimens. The long-term regimen (LTR) consists of treatment for 18-20 months, while the short-term regimen (STR) was 11 months, based on the latest World Health Organization (WHO) consolidated guidelines on drug-resistant tuberculosis. Data analyses were conducted with utilizing the SPSS (v.29.0) Results A total of 178 DR-TB patients were enrolled in this study. Gender distribution showed 45 males (47.36%) and 50 females (52.63%) in the STR group, and 46 males (55.42%) and 37 females (44.57%) in the LTR group. Significant age differences were noted, with mean ages of 34.16 years (±16.76) in the STR group and 41.71 years (±18.44) in the LTR group. Treatment outcomes revealed an 86.31% treatment success rate in the STR group vs 79.51% in the LTR group, with death rates of 4.21% vs. 9.63%. Conclusion Our findings suggest that, while both approaches produce comparable treatment success rate, however, short-term regimens may be a viable alternative to long-term treatments in specific patient groups that are younger, potentially improving adherence and lowering healthcare costs.References
Liang S. Deep learning for precise diagnosis and subtype triage of drug‐resistant tuberculosis on chest computed tomography. Medcomm. 2024;5(3). DOI: 10.1002/mco2.487
Delgado L, Postigo M, Cuadrado D, Gil-Casanova S, Martinez A, Linares M. et al. Remote analysis of sputum smears for mycobacterium tuberculosis quantification using digital crowdsourcing. PLoS ONE. 2022;17(5):e0268494. DOI: 10.1371/journal.pone.0268494
Tasnim T, Tarafder S, Alam F, Sattar H, Kamal S. Pre-extensively drug resistant tuberculosis (pre-xdr-tb) among pulmonary multidrug resistant tuberculosis (mdr-tb) patients in Bangladesh. J Tuberc Res. 2018;06(03):199-206. DOI: 10.4236/jtr.2018.63018
Problems of multidrug- and extensively drug-resistant TB. Drug Ther Bull. 2012;50(2):21-24. DOI: 10.1136/dtb.2012.02.0087.
Bereda G. Management of drug resistant tuberculosis: isoniazid resistant, rifampicin resistant, multi drug resistant, and extensively drug resistant. J Lung Pulm Respir Res. 2022;9(2):46-50. DOI: 10.15406/jlprr.2022.09.00279.
Ponmalar I, Swain J, Basu J. Escherichia coli response to subinhibitory concentration of colistin: insights from study of membrane dynamics and morphology. 2022. DOI: 10.1101/2022.01.16.476501.
Jain N. WHO consolidated guidelines on tuberculosis 2020 moving toward fully oral regimen: should country act in hurry?. Lung India. 2021;38(4):303. DOI: 10.4103/lungindia.lungindia_982_20.
Hofman S, Segers M, Ghimire S, Bolhuis M, Sturkenboom M, Soolingen D. et al. Emerging drugs and alternative possibilities in the treatment of tuberculosis. Expert Opin Emerg Drugs. 2016;21(1):103-116. DOI: 10.1517/14728214.2016.1151000.
Althubaiti A. Sample size determination: A practical guide for health researchers. J Gen Fam Med. 2022;24(2):72-78. DOI: 10.1002/jgf2.600.
World Health Organization. WHO Consolidated Guidelines on Drug-resistant Tuberculosis Treatment. Geneva: World Health Organization; 2019.
Nunn A, Phillips P, Meredith S, Chiang C, Conradie F, Dalai D. et al. A trial of a shorter regimen for rifampin-resistant tuberculosis. N Engl J Med. 2019;380(13):1201-1213. DOI: 10.1056/nejmoa1811867.
Hamdouni M, Bourkadi J, Benamor J, Hassar M, Cherrah Y, Ahid S. Treatment outcomes of drug resistant tuberculosis patients in Morocco: multi-centric prospective study. BMC Infect Dis. 2019;19(1). DOI: 10.1186/s12879-019-3931-5.
Tang S, Tan S, Yao L, Li F, Li L, Guo X. et al. Risk factors for poor treatment outcomes in patients with mdr-tb and xdr-tb in China: retrospective multi-center investigation. PLoS ONE. 2013;8(12):e82943. DOI: 10.1371/journal.pone.0082943.
Nunn A, Phillips P, Meredith S, Chiang C, Conradie F, Dalai D. et al. A trial of a shorter regimen for rifampin-resistant tuberculosis. N Engl J Med. 2019;380(13):1201-1213. DOI: 10.1056/nejmoa1811867.
Abidi S, Achar J, Neino M, Bang D, Benedetti A, Brode S. et al. Standardised shorter regimens versus individualised longer regimens for rifampin- or multidrug-resistant tuberculosis. Eur Respir J. 2019;55(3):1901467. DOI: 10.1183/13993003.01467-2019.
Ahmad N, Ahuja S, Akkerman O, Alffenaar J, Anderson L, Baghaei P. et al. Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis. Lancet. 2018;392(10150):821-834. DOI: 10.1016/s0140-6736(18)31644-1.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Pakistan Journal of Chest Medicine

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.