Is it worth treating Category I failure patients with Category II regimen?

Santha, T.; Gopi, P.G.; Rajeswari, R.; Selvakumar, N.; Subramani, R.; Chandrasekaran, V.; Rani, B.; Thomas, A.; Narayanan, P.R.

Indian Journal of Tuberculosis; 2005; 52; 203-206.

Summary: Background : Very little information is available on the drug susceptibility profile among patients who are treated with standardized short-course chemotherapy regimens under programme conditions.

Methods: Sputum samples were collected from new sputum smear-positive patients declared ‘failure' after treatment with Category I regimen under tuberculosis control programme using DOTS strategy from a rural area of Tamil Nadu.

Results: Of 1463 patients started on Category I regimen between May 1999 and December 2002, 74 cases were declared as ‘failures' (smear positive at 5/6 months of treatment). We collected sputum samples from 60 (81%) of 74 ‘failures' and 27% (16 of 60) of them were culture-negative for M. tuberculosis and 17% (10 of 60) had organisms resistant to Isoniazid and Rifampicin (MDR TB).

Conclusion: Based on the drug susceptibility profile at the time of ‘failure', treating Category I ‘failures' with Category II regimen with close monitoring appears to be justified.

Keywords: Tuberculosis, DOTS

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