Use of drug-susceptibility testing for management of drug-resistant tuberculosis, Thailand, 2004-2008

In 2004, routine use of culture and drug-susceptibility testing (DST) was implemented for persons in 5 Thailand provinces with a diagnosis of tuberculosis (TB). To determine if DST results were being used to guide treatment, we conducted a retrospective chart review for patients with rifampin-resist...

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Bibliographic Details
Published in:	Emerging infectious diseases Vol. 20; no. 3; pp. 400 - 416
Main Authors:	Lam, Eugene, Nateniyom, Sriprapa, Whitehead, Sara, Anuwatnonthakate, Amornrat, Monkongdee, Patama, Kanphukiew, Apiratee, Inyaphong, Jiraphan, Sitti, Wanlaya, Chiengsorn, Navarat, Moolphate, Saiyud, Kavinum, Suporn, Suriyon, Narin, Limsomboon, Pranom, Danyutapolchai, Junya, Sinthuwattanawibool, Chalinthorn, Podewils, Laura Jean
Format:	Journal Article
Language:	English
Published:	United States U.S. National Center for Infectious Diseases 01-03-2014 Centers for Disease Control and Prevention
Subjects:	Adult anti-tuberculosis treatment Antitubercular agents Antitubercular Agents - pharmacology Antitubercular Agents - therapeutic use bacteria clinical management Drug Resistance, Multiple, Bacterial Drug therapy Drug Therapy, Combination Female Health aspects Humans laboratory testing Male Microbial Sensitivity Tests Middle Aged Mycobacterium tuberculosis - drug effects Public Health Surveillance Retreatment Risk Factors Thailand Treatment Failure treatment management Treatment Outcome Tuberculosis Tuberculosis, Multidrug-Resistant - diagnosis Tuberculosis, Multidrug-Resistant - drug therapy Tuberculosis, Multidrug-Resistant - epidemiology Thailand clinical management bacteria rifampin-resistant tuberculosis tuberculosis drug susceptibility testing multidrug-resistant tuberculosis Thailand TB anti-tuberculosis treatment treatment management tuberculosis and other mycobacteria MDR TB drug resistance laboratory testing
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Summary:	In 2004, routine use of culture and drug-susceptibility testing (DST) was implemented for persons in 5 Thailand provinces with a diagnosis of tuberculosis (TB). To determine if DST results were being used to guide treatment, we conducted a retrospective chart review for patients with rifampin-resistant or multidrug-resistant (MDR) TB during 2004-2008. A total of 208 patients were identified. Median time from clinical sample collection to physician review of DST results was 114 days. Only 5.8% of patients with MDR TB were empirically prescribed an appropriate regimen; an additional 31.3% received an appropriate regimen after DST results were reviewed. Most patients with rifampin -resistant or MDR TB had successful treatment outcomes. Patients with HIV co-infection and patients who were unmarried or had received category II treatment before DST results were reviewed had less successful outcomes. Overall, review of available DST results was delayed, and results were rarely used to improve treatment.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1080-6040 1080-6059
DOI:	10.3201/eid2003.130951