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Objectives: Multi Drug Resistant (MDR) TB is threatening global TB control. It’s one of the basic public health problems. In our study, we aimed to evaluate the patients who were diagnosed and treated as XDR TB in our hospital.
Methods: We evaluated microbiological diagnosis, resistance tests (all dispatched laboratory records), age, gender, nationality, treatment regimens of the patients who were treated as MDR TB between the years 2013-2018.
Results: 265 patients with an average age of 39±14 were diagnosed and treated as MDR TB. 184 of 265 patients (69.2%) were male and 59 (22.2%) were foreign nationality. 159 of 265 (59.8%) were classified as previously treated patients. 21 of 265 (7.9%) had rifampicin resistance without isoniacid resistance, 244 (92.1%) had HR resistance. Pyrazinamide drug sensitivity test was attempted for 147 of 265 (55.3%) patients (Pyrazinamide resistance was detected in 39) Second-line drug susceptibility testing was attempted for 198 of 265 (74.3%) patients. Among 198 patients, 13 (4.8%) had amikacin, 20(10.1%) had quinolone, 155 (58.3%) had ethionamide, 17 (6.4%) had PAS resistance. Linezolid resistance was studied for 137 of 265 (51.5%) patients (2 of them had linezolid resistance). Evaluation of treatment regimens of 265 patients revealed that isoniyazid was used in 21 (7.9%), pyrazinamide in 142 (53.4%), ethambutol in 51 (19.2%), amikacin in 212 (79.7%), quinolone in 258 (96.9 %), (moxifloxacin in 251, levofloxacin in 7), ethionamide in 212 (79.7%), PAS in 220 (82.7%), linezolid in 58 (21.8 %), clofazimine in 31 (11.7%), amoksasilin+clavulanate in 3 (1.1%). For treatment regimen, the duration of the parenteral drug treatment was used as 4 to 6 months and total treatment time was planned as 18 months after culture negativity. Treatment results of patients are followed.
Conclusion: MDR TB treatment regimen takes a long time to complete, has a lot of side effects and high rates of treatment default. Early diagnosis, an effective and appropriate treatment, maintenance and the continuation of the drug resistant treatment is important for the TB control program.