Abstract:

Objective To analyze the prevalence of multidrug-resistant tuberculosis (MDR-TB) after treatment with different regimens in patients with mono-resistance to isoniazid (H) and rifampicin (R), in order to guide rational drug use in clinical settings.Methods From January 2010 to December 2014, 332 pulmonary tuberculosis patients with mono-resistance to H and 114 pulmonary patients with mono-resistance to R identified by the drug resistance surveillance project in Puyang City, He’nan Province were enrolled as the study subjects. The subjects were randomized (through simple randomization among patients with mono-resistance to H and R respectively) into standard chemotherapy group (a total of 222 cases on regimens according to the standardized chemotherapy for na?ve and retreated patients, referred to as “standard group”); and the levofloxacin chemotherapy group (a total of 224 cases on regimens based on the drug sensitivity test results, containing levofloxacin chemotherapy, referred to as “levofloxacin group”). The incidence of MDR-TB after treatment in both groups was observed. SPSS 20.0 statistical software package was used for statistical analysis, and the group comparison was performed using χ ² test. P<0.05 was considered statistically significant. Results The incidence of MDR-TB was 11.7% (26/222) in the standard group, and 4.9% (11/224) in the levofloxacin group and the difference was statistically significant (χ ²=6.779, P=0.009). Among the newly diagnosed patients, the incidence of MDR-TB was 4.4% (8/180) in the standard group and 2.2% (4/185) in the levofloxacin group, with no significant difference between the two (χ ²=1.495,P=0.222). Among the retreated patients, the incidence of MDR-TB was 42.9% (18/42) in the standard group and 17.9% (7/39) in the levofloxacin group, with statistical difference (χ ²=5.880, P=0.015). Among the patients with mono-resistance to R, the incidence of MDR-TB was 37.5% (21/56) in the standard group and 17.2% (10/58) in the levofloxacin group, with the difference being statistical significance (χ ²=5.906, P=0.015). Among the retreated patients with mono-resistance to R, the incidence of MDR-TB was 56.5% (13/23) in the standard group, and 27.3% (6/22) in the levofloxacin group, and the difference was statistically significant (χ ²=3.493, P=0.047). Conclusion Among naive patients with mono-resistance to H and R, standard chemotherapy does not increase the risk of developing MDR-TB. Pulmonary tuberculosis patients with mono-resistance to R are more prone to develop MDR-TB, compared with those with mono-resistance to H, especially those retreated patients with mono-resistance to R.

Key words: Tuberculosis,pulmonary, Drug resistance, Drug therapy,combination, Clinical regimens, Treatment outcome, Data interpretation,statistics