Prognostic factors for treatment success in patients with multidrug-resistant tuberculosis in China

Int J Tuberc Lung Dis. 2018 Mar 1;22(3):300-305. doi: 10.5588/ijtld.17.0183.

Abstract

Objective: To examine the clinical outcomes and associated prognostic factors among patients with multidrug-resistant tuberculosis (MDR-TB) in China.

Methods: This retrospective study involved 243 patients with MDR-TB. All patients received standard regimens containing para-amino salicylic acid (PAS) and/or cycloserine (CS). The demographic, social and clinical characteristics of patients were recorded and the patients were followed up for 24 months.

Results: Treatment success was closely associated with young age, non-farming occupations, shorter history or smoking, normal urine results, initial MDR-TB treatment regimen, increased haemoglobin, direct bilirubin, uric acid and thyroid stimulating hormone (TSH) levels, and lower white blood cell, neutrophil and blood platelet counts (all P < 0.05). On multivariable analysis, increased haemoglobin (hazard ratio [HR] 1.019, 95%CI 1.007-1.032, P = 0.002) and TSH levels (HR 1.002, 95%CI 1.006-1.039, P = 0.008), normal urine results (HR 1.541, 95%CI 1.008-2.358, P = 0.046) and initial MDR-TB treatment regimen (HR 2.238, 95%CI 1.090-4.597, P = 0.028) were prognostic factors for treatment success in MDR-TB.

Conclusions: Higher haemoglobin and TSH levels, normal urine results and initial MDR-TB treatment regimen might predict successful treatment of MDR-TB.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aminosalicylic Acid / therapeutic use*
  • Antitubercular Agents / therapeutic use*
  • Child
  • China
  • Cycloserine / therapeutic use*
  • Drug Administration Schedule
  • Female
  • Hemoglobins / analysis
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Thyrotropin / blood
  • Treatment Failure
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Urinalysis
  • Young Adult

Substances

  • Antitubercular Agents
  • Hemoglobins
  • Aminosalicylic Acid
  • Thyrotropin
  • Cycloserine