Analysis of treatment in newly diagnosed patients according to drug-sensitive tuberculosis regimen

The main problem in the treatment of tuberculosis (TB) patients is the increase in drug resistance of M.tuberculosis, which is not always detected at the start of chemotherapy, which leads to inadequate and lengthy treatment. Research objective . Analysis of the treatment of newly diagnosed patients according to the regimen of drug-sensitive TB. Materials and methods . We analyzed the facts of correction of the regimen and the timing of the intensive phase of chemotherapy in 55 newly diagnosed patients with pulmonary TB who were taken for treatment according to regimen of drug-sensitive TB in 2019–2021. Results . At the start of treatment, bacterial excretion and drug sensitivity of M. tuberculosis were confirmed by microscopy and molecular genetic tests only in 9 (16.4%) patients. Results of cultural tests confirm the bacterial excretion in 23 (41.8%) patients. Of these, 10 patients (43.6%; 18.2% of those who started treatment, 21.7% with no data on bacterial excretion at the start of chemotherapy) received data on drug resistance during treatment (7 – MDR, 2 – pre-XDR, one had resistance to isoniazid), which required a change in regimen with an extension of the intensive phase to 8 months. Of the remaining 45 patients, in 29 the duration of the intensive phase was 2 months, in 15 with HIV infection – 3 months; in one patient the intensive phase was prolonged to 5 months due to poor tolerability. Conclusion . A change of treatment regimen due to drug resistance was required in 18.2% of newly diagnosed TB patients with suspected drug sensitivity of the pathogen. It is necessary to improve management strategies for newly diagnosed patients with oligobacillary pulmonary tuberculosis.