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164 human immunodeficiency virus (HIV) seronegative pulmonary tuberculosis cases treated in our clinic between January 1997 to December 2005 and included in category two treatment group were evaluated retrospectively. All the cases were male. The mean age was 43.72 ± 12.73 years. The mean duration of disease was 3.96 ± 4.80 years. The patients had used mean 4.62 ± 0.86 types of drugs. The patients were hospitalized for mean 100.54 ± 67.43 days. 23 (14%) patients were defined as treatment failure. 42 (25.6%) patients were relapse and 99 (60.4%) were defaulter. Mean time of conversion was 2.62 ± 1.84 months. Conversion rate was higher in relapse cases (76.2%) compared with treatment failure (56.5%) and defaulter (57.6%). In 140 patients, resistance tests were performed. 73 (52.1%) patients had any drug resistance. 45 (32.1%) patients had multidrug resistance. Among all the patients, 7 (4.3%) patients had died. 48 (29.3%) patients defaulted. 33 (20.1%) had treatment failure. 76 (46.3%) had cured. The cure rate was 65.5% in patients who were in control. 36.4% of defaulters were out of control. This rate was significantly higher than relapse and treatment failure cases (p= 0.014). Cure rate in defaulters (38.4%) were significantly lower than relapses (61.9%) and treatment failures (52.2%). There was a significant relationship between any drug resistance and cure and conversion. There was also a significant relationship between positive second and third ARB and culture and treatment success. As a result, a chance to retreatment regimen can be given in relapses and treatment failures before deciding minor drug therapy because they have higher cure rates than defaulters. Defaulters are hard to cure. They have the tendency to default again and they have higher resistance rates. The multi drug resistance rate in all patients was about 32% and 46.7% of these have cured with retreatment regimen. Bacteriological follow up of treatment outcome is effective in management of therapy.

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http://dx.doi.org/10.5578/tt.1932DOI Listing

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