Abstract:

Objective To investigate the efficacy, compliance and adverse reactions of short-course chemotherapy in the patients with retreated pulmonary tuberculosis for the first time, and to provide evidence for clinical diagnosis and treatment. Methods A total of 101 eligible retreated tuberculosis patients admitted to Anhui Chest Hospital from June 2018 to March 2021 were enrolled and randomly divided into two groups. The short-course regimen group (73 cases) was given moxifloxacin, rifambutin, isoniazid aminosalicylate, pyrazinamide and ethambutol for 6 months, and the 28 patients in standard treatment group were treated with isoniazid, rifampicin, pyrazinamide and ethambutol for 3 months during the intensive phase, and isoniazid, rifampicin and ethambutol for 6 months during the continuation period. The 2-month sputum conversion rate, treatment success rate, imaging focus absorption rate and adverse reactions were compared between the two groups. Results The 2 month sputum negative conversion rate (69.0%, 29/42) in short-course regimen group was higher than that in standard regimen group (41.2%, 7/17), the difference was statistically significant (χ²=3.952, P=0.047).The treatment success rate of the short-course regimen group was 78.1% (57/73), which was higher than that of the standard regimen group (60.7%, 17/28), the difference was statistically significant (Fisher’s test, P=0.039). The absorption of the lesions in the short-course regimen group was significantly better than that in the standard control group. In the short-course regimen group, there were 4 cases of total absorption (7.0%), 24 cases of obvious absorption (42.1%), 29 cases of absorption (50.9%), 0 case of constant absorption (0.0%), and 0 case of deterioration (0.0%). In the standard treatment group, there were 0 case of total absorption (0.0%), 3 cases of obvious absorption (17.6%), 13 cases of absorption (76.5%), 1 case of constant absorption (5.9%), and 0 case of deterioration (0.0%), and there was a significant difference between the two groups (Fisher’s test, P=0.046). The incidence of adverse reactions was 11.0% (8/73) in the short-course regimen group and 14.3% (4/28) in the standard course group, with no significant difference (χ²=0.014, P=0.905). Conclusion In the treatment process of the first retreatment of pulmonary tuberculosis patients, patients in the short-course regimen group have higher compliance compared with the standard regimen group, and the short-course regimen is conducive to sputum negative conversion and lesion absorption, and could significantly shorten the treatment time and improve the efficacy.

Key words: Tuberculosis,pulmonary, Retreatment, Chemotherapy regimens