Background: Treatment of multidrug-resistant tuberculosis (MDR-TB) in the Programmatic Management of Drug-resistant TB program involves a standard regimen with a 6-month intensive phase and an 18-month continuation phase. However, the local drug resistance patterns in high MDR regions such as Mumbai may not be adequately reflected in the design of the regimen for that particular area.
Setting: The study was carried out at a private Tertiary Level Hospital in Mumbai in a mycobacteriology laboratory equipped to perform the second-line drug susceptibility testing (DST).
Objective: We attempted to analyze the impact of prescribing the standardized Category IV regimen to all patients receiving a DST at our mycobacteriology laboratory.
Materials And Methods: All samples confirmed to be MDR-TB and tested for the second-line drugs at Hinduja Hospital's Mycobacteriology Laboratory in the year 2012 were analyzed.
Results: A total of 1539 samples were analyzed. Of these, 464 (30.14%) were MDR-TB, 867 (56.33%) were MDR with fluoroquinolone resistance, and 198 (12.8%) were extensively drug-resistant TB. The average number of susceptible drugs per sample was 3.07 ± 1.29 (assuming 100% cycloserine susceptibility). Taking 4 effective drugs to be the cut or an effective regimen, the number of patients receiving 4 or more effective drugs from the standardized directly observed treatment, short-course plus regimen would be 516 (33.5%) while 66.5% of cases would receive 3 or less effective drugs.
Conclusion: Our study shows that a high proportion of patients will have resistance to a number of the first- and second-line drugs. Local epidemiology must be factored in to avoid amplification of resistance.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857559 | PMC |
| http://dx.doi.org/10.4103/0970-2113.180800 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Continuous individual feedback to nurses at emergency medical dispatch centres: a stepped-wedge, interrupted time series analysis.
BMJ Open Qual
January 2025
Uppsala Center for Prehospital Research, Institute of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Background: Clinical feedback is often lacking in prehospital care, and while performance data is increasingly available to clinical and operational leadership, it is seldom made available to care providers themselves. In this study, we investigate the impact of a simple intervention consisting of the provision of monthly feedback reports via email to emergency medical dispatch nurses in three Swedish regions.
Method: Individualised reports consisting of 14 measures divided into descriptive (eg, priority-setting and call times), process (eg, dispatch times and documentation completeness) and outcome (eg, over/under triage rate) categories were developed with staff and management input.
Head or skull injury? Consequences of using mistranslated ICD diagnosis category: Multicenter, blinded, randomized controlled analysis.
J Forensic Leg Med
January 2025
Department of Traumatology and Hand Surgery, University of Pécs Clinical Centre, Hungary.
Emergency care units in Hungary treat approximately 140-180 thousand head injuries of varying se'verity each year. These head injuries are mainly caused by traffic accidents, assaults, or domestic accidents. The outpatient care record contains details about the circumstances and underlying mechanisms of the head injury, the results of physical and imaging examinations, and therapeutic recommendations.
View Article and Find Full Text PDFCommunicating with Stakeholders to Identify High-Impact Research Directions for Non-Targeted Analysis.
Anal Chem
January 2025
Center for Devices and Radiological Health, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, Maryland 20993, United States.
Non-targeted analysis (NTA) using high-resolution mass spectrometry without defined chemical targets has the potential to expand and improve chemical monitoring in many fields. Despite rapid advancements within the research community, NTA methods and data remain underutilized by many potential beneficiaries. To better understand barriers toward widespread adoption, the Best Practices for Non-Targeted Analysis (BP4NTA) working group conducted focus group meetings and follow-up surveys with scientists (n = 61) from various sectors (e.
View Article and Find Full Text PDFExploring the textural characteristics of foods preferred by Chinese elderly individuals based on IDDSI levels.
PLoS One
January 2025
Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China.
Objective: This study aimed to investigate the textural characteristics of foods preferred by elderly Chinese individuals and their suitability based on the International Dysphagia Diet Standardization Initiative (IDDSI) framework. The goal was to provide objective data to support the development of safe and nutritious diets tailored to the swallowing abilities of the elderly.
Methods: A cross-sectional observational study was conducted, using web-scraping technology to identify 26 commonly preferred food ingredients among elderly individuals across seven regions of China.
Revised Process for ACNS Guidelines Development.
J Clin Neurophysiol
February 2025
Division of Child Neurology, Department of Neurology, Stanford University, Palo Alto, California, U.S.A.
The development of clinical practice guidelines is an evolving field. In response to the need for consistent, evidence-based medical practice, the American Clinical Neurophysiology Society identified the need to update the Society's guideline development process. The American Clinical Neurophysiology Society Guidelines Committee created an action plan with the goal of improving transparency and rigor for future guidelines and bringing existing guidelines to current standards.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!