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Sung Il Choi, Joong Ho Bae, Suck Jun Kong, Joo Hong Park |
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이화여자대학교 의과대학 내과학교실, 의과학연구소, 병리학교실* |
| 원저 : 한 결핵전문병원의 약제내성결핵실태와 치료성적 (Original Articles : The actual condition of drug-resistant tuberculosis and treatment outcomes at a tuberculosis specialized hospital) |
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최성일, 배중호, 공석준, 박주홍 |
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| Abstract |
Background : During the last decade, the reports of drug-resistant tuberculosis in Korea were not
common. Therefore, we investigated the anti-tuberculosis drug resistance rate according to medical
history and radiological findings, as well as the relationship between the drug resistance and
treatment outcomes to provide guidelines for selection of drug regimen before drug sensitivity test.
Methods
: The study population was composed of 745 hospitalized patients who received drug
susceptibility test for M. tuberculosis and anti-tuberculosis chemotherapy for the last 5 years.
Results
: The majority had resistance to at least one drug (91.3%; 3.8±2.6 drugs). Drug
resistance rate of first line drugs was 25～55%; especially higher in retreatment cases and those with
the cavity on chest X-ray. Drug resistance was not correlated with radiographic finding. The success
rate for treatment was higher in new cases, patients with less severe disease status and those
without cavity on chest X-ray. When new cases had no resistance to all of EHR (84.1%), the
negative conversion rate by first line drugs was above 70～90%. For retreatment patients, the
negative conversion rate was above 70% only when they were susceptible to all of EHR (31%). The
relapse rate was 4～13%.
Conclusions
: Probably the prevalence of drug-resistant tuberculosis in Korea will be
considerably high. The drug resistance and treatment outcome was affected more by history of
previous medical treatment than radiological findings. The previous EHRZ regimen is very effective
as the initial treatment in new case, but revised retreatment regimen composed of at least 4 drugs
is needed in the previously treated patients.(Korean J Med 70:172-182, 2006)
Key Words : Drug-resistant tuberculosis, Treatment outcome, Medical history taking, Thoracic radiography |
| Key Words:
Drug-resistant tuberculosis, Treatment outcome, Medical history taking, Thoracic radiography |
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