Abstract: Abstract：Objective  To examine the rationality of MDR-TB standardized treatment regimen according to the MDR-TB baseline survey results in China Global Fund MDR-TB pilot areas-Wuhan and Shenzhen. Methods  One hundred and five MDRTB bacterial strains acquired from drug resistant surveillance in Shenzhen and Wuhan during January 1 to December 31 of 2008 were given drug susceptibility test (DST) for stréptomycin(S), ethambutol(E),  kanamycin (Km), and ofloxacin(Ofx). Among them, 58 bacterial strains came from new patients and 47 came from retreatment cases. The rationality of treatment regimen was analyzed based on the drug resistant spectrum. Test results were entered into database designed by Epidata and SAS was used for data analysis. Constituent ratios of drug resistance status were described. χ² test and Fisher's exact test were used to examine the difference between groups for enumeration data. P  value<0.05 was considered statistically significant.  Results  Among the 105 MDR-TB strains, 74.3%, 41.0%, 11.4% and 22.9% of strains were resistant to S, E, Km and Ofx respectively. The resistant proportions to these four drugs were 75.9%, 41.4%, 10.3%, 19.0% respectively for new cases and 72.3%, 40.4%, 12.8%, 27.7% for retreatment cases. There has no statistically significant difference between new cases and retreatment cases in terms of the resistance proportion to the four drugs (χ² are 0.001, 0.013, 0.231 and 1.423 respectively, all  P＞0.05). In Shenzhen, the resistant proportions to these four drugs were 76.0%, 40.0%, 16.0% and 4.0% for new cases and 68.8%, 43.8%, 6.3% and 18.8% for retreatment cases. In Wuhan, these proportions were 75.8%, 42.4%, 6.1% and 30.3% for new cases, and 74.2%, 38.7%, 16.1% and 32.3% for retreatment cases. Comparison between Shenzhen and Wuhan showed that for new patients, Ofx resistant in Wuhan is significantly higher than that in Shenzhen (χ²=6.4033, P＜0.05). Between the two cities, there has no significant difference in other three drugs for new cases and in all drugs for retreatment cases. Conclusion  The current standardized regimen is applicable to new and retreatment MDR-TB cases in Shenzhen, however, whether Ofx could be taken as one of main drugs in Wuhan needs to be further studied.

Key words: Tuberculosis, multidrug-resistant/drug therapy, Clinical protocols