The Analysis of Risk Factors of Treatment Failure in MDR-TB / 결핵

ABSTRACT

BACKGROUND: Outbreaks of multidrug-resistant tuberculosis(MDR-TB) are caused by the low rate of treatment response due to limitation in number of available drugs and high rates of adverse drug side-effects. This study analysed the risk factors for MDR-TB patients, who did not respond to treatment, with an aim to improve the rate of treatment response. METHODS: Retrospective study of 111 MDR-TB patients at National Mokpo Tuberculosis Hospital from Jan. 1996 to Dec. 1998 was made. The patients were separated into tow groups ; group I comprised of patients who were treated successfully and group II comprised of those were not treated successfully. In order to analyze the risk facotrs for treatment faulure, differences between the two groups were compared and the confidence limit regarding the results were tested using an independent t-test, chi-square test and a Fisher's exact tets. RESULTS: The treatment failure rate of MDO-TB patients was 32% (36 patients), and treatment success rate 68%(75 patients). This study found no significant difference between two groups in terms of age, sex, family history, extent of the disease on the chest X-ray, the number of sensitive drugs in the treatment regimen, and the number of sensitive bactericidal drugs in the treatement regimen (p>0.05). However, a past history of pulmonary tuberculosis, cavitary lesions on the chest X-ray, the number of tretaments, the number of resistant drugs and the number of drugs used showed a significant difference(p<0.05). CONCLUSION: The rate of treatment failure in MDR-TB was increased by a past history of pulmonary tuberculosis, cavitary lesions on the chest X-ray, the number of treatments, the number of resistant drugs and the number of drugs used. For improving the treatment response of MDR-TB, every effort should be made to reduce the drug resistance caused by failure of the first treatment.