Evaluation of effectiveness on a new chemotherapy regimen for the initial treatment of smear-positive tuberculosis in the elderly / 中华老年医学杂志

ABSTRACT

Objective To evaluate the efficacy of the new treatment regimen versus the standardized scheme for the initial treatment of smear-positive tuberculosis in the elderly.Methods A total of 302 elderly patients meeting the inclusion and exclusion criteria were selected from 14 tuberculosis-designated medical institutions in Beijing.The patients received the initial treatment of smear-positive tuberculosis from January 2014 to August 2016 in the combined prospective and retrospective study.All patients were divided into observation group(n=63)receiving treatment with 6L2 HELfx regimen from August 1,2015 to August 31,2016,and control group (n =239) receiving treatment with 6L2HELfx regimen from January 1,2014 to January 31,2015.The nation-unified standard chemotherapy regimen 2RHZE/4RH was used in tuberculosis medical service institutions for all patients.The differences between the two groups were analyzed and compared in the completion of treatment,negative conversion of sputum culture or smear,adverse drug reactions and treatment outcome.Results The completion rate of long-course therapy was significantly higher in the observation group than in control group [90.5％ (57/63) vs.79.5％ (190/239),x2 =4.034,P =0.045].The rate of negative conversion of sputum culture or smear at the end of the 2nd month was higher in the observation group than in control group,but had no significant difference[87.0％ (47/54)vs.81.6％(155/190),x2 =0.879,P=0.349].The incidence of adverse reactions was much lower in observation group than in control group[46.0％ (29/63) vs.65.3％ (156/239),x2 =7.777,P =0.005].The success rate of treatment(cure or completion of long-course therapy)was higher in observation group than in control group [90.5％ (57/63) vs.77.4％ (185/239),x2 =5.350,P =0.021].ConclusioNS As compared with the standard chemotherapy regimen,the L and Lfxcontaining treatment regimen has better effects,higher success rate of treatment and less adverse reactions in elderly patients with the initial treatment of smear-positive tuberculosis.