Main causes of chemotherapy inefficiency in patients with multidrug-resistant pulmonary tuberculosis

Abstract

BACKGROUND. Research results in patients with multidrug-resistant pulmonary tuberculosis (MDR-TB) in the dynamics of treatment.

OBJECTIVE. To study the main causes of chemotherapy inefficiency in patients with MDR-TB.

MATERIALS AND METHODS. Comprehensive examination of 176 patients with MDR-TB, which was divided into two groups: new cases of disease (95 patients) and repeated cases (81 patients).

RESULTS. The study has shown that patients with the following prognostic criteria are at high risk for the development of MDR-TB: history of anti-tuberculosis treatment, common destructive processes in the lungs, massive bacterial excretion, non-adherence to treatment.

CONCLUSIONS. The main reasons for the ineffectiveness of chemotherapy in patients with MDR-TB are the process prevalence (82.8 %), massive bacterial excretion (38.2 %), the presence of multiple decay cavities (84.3 %), rapid transfer to the outpatient stage of bacterial excretion (17.9 %), termination of inpatient treatment in the intense phase (35.8 %), non-adherence to treatment (35.8 %).

Keywords: causes, inefficiency, chemotherapy, multidrug-resistant tuberculosis, lung.

References

Barbova A. I., Zhurylo O. A., Trofimova P. S. et al. Suchasni pidkhody shchodo provedennia bakteriolohichnoi identyfikatsii mikobakterii [Current approaches to bacteriological identification of mycobacteria]. Ukr. pulmonol. zhurn. 2013; 3: 28-32.

Lytvynenko N. A., Cherenko S. O., Pohrebna M. V. et al. Ratsionalnyi vybir indyvidualizovanykh rezhymiv khimioterapii dlia khvorykh na multyrezystentnyi tuberkuloz ta tuberkuloz iz rozshyrenoiu rezystentnistiu MBT do protytuberkuloznykh preparativ [The rational choice of individualized chemotherapy regimens for patients with multidrug-resistant tuberculosis and tuberculosis with extended MBT resistance to antituberculosis drugs]. Tuberkuloz, lehenevi khvoroby, VIL‑infektsiia. 2013; 4 (15): 46-54.

Melnyk V. M., Novozhylova I. O., Matusevych V. H. et al. Efektyvnist likuvannia khvorykh na multyrezystentnyi tuberkuloz v Ukraini: analiz ofitsiinoi zvitnosti [Effectiveness of treatment of patients with multidrug-resistant tuberculosis in Ukraine: analysis of official reports]. Ukr. pulmonol. zhurn. 2014; 2: 36-39.

Nizova N. M. Tuberkuloz v Ukraini: Analitychno-statystychnyi dovidnyk [Tuberculosis in Ukraine: An analytical and statistical reference book]. – K., 2019. – 115 p.

Petrenko V. I., Dolynska M. H. Obiednuiemosia, shchob poklasty krai tuberkulozu [Uniting to put an end to tuberculosis]. Tuberkuloz, lehenevi khvoroby, VIL‑infektsiia. 2016; 1 (24): 5-6.

Todoriko L. D., Humeniuk M. I., Shevchenko O. S., Yeremenchuk I. V., Semianiv I. O. Prohnostychnyi analiz sytuatsii z tuberkulozu u sviti za rezultatamy shchorichnoi dopovidi VOOZ [Prognostic analysis of the global tuberculosis situation, based on the WHO annual report]. Infusion & Chemotera. 2019; 4: 5-9. DOI: 10.32902/2663-0338-2019-4-10-17.

Tuberkulez: vyiavlenye, lechenye i monytorynh po K. Tomenu. Voprosy i otvety [Tuberculosis: detection, treatment and monitoring according to K. Tomen. Questions and answers] / Ed. by T. Fryden. – Zheneva: Vsemyrnaia orhanyzatsyia zdravookhranenyia, 2004. – 386 p.

Feshchenko Y. I., Melnyk V. M., Humeniuk M. I., Lynnyk M. I. Epidemiolohichna sytuatsiia z tuberkulozu v Ukraini [The epidemiological situation of tuberculosis in Ukraine]. Infusion & Chemotera. 2019; 4: 5-9. DOI: 10.32902/2663-0338-2019-4.

Feshchenko Y. I., Todoriko L. D., Kuzhko M. M., Humeniuk M. I. Patomorfoz tuberkulozu – realii sohodennia, khimiorezystentnist yak oznaka prohresuvannia [Tuberculosis pathomorphosis – the realities of today, chemoresistance as a sign of progression]. Ukr. pulmonol. zhurn. 2018; 2: 6-10. DOI: 10.31215/306-4927-2018-100-2-2-10.

Cherenko S. O., Hrankina N. V., Pohrebna M. V. Tryvalist intensyvnoi fazy khimioterapii pry likuvanni khvorykh na multyrezystentnyi tuberkuloz [Duration of intensive phase of chemotherapy in the treatment of patients with multidrug-resistant tuberculosis]. Tuberkuloz, lehenevi khvoroby, VIL‑infektsiia. 2014; 4 (23): 7-11.

Duraisamy K. et al. Does alcohol consumption multidrug-resistant tuberculosis treatment affect outcome? Ann. Am. Thorax. SOS. 2014: 5 (11): 712-718.

Gehlberg I. S., Wolff S. B., Alex E. N. Indicators of liver function in patients with MDR-TB patients and their dynamics in the course of chemotherapy. HIV‑associated TB: epidemiological, clinical and social aspects: materials of the international scientific-practical conference on October 29-30, 2015 in Grodno: Abstracts. Grodno (Belarus). 2015: 176-177.

Caminero J. A. Multi-drug resistant tuberculosis: epidemiology, risk, factors and case finding. Int. J. Tuberc. Lung Dis. 2010; 14: 382-390.

Published
2020-02-18
How to Cite
Sakhelashvili, M. I., Platonova, I. L., Sakhelashvili-Bil, O. I., & Tlustova, T. V. (2020). Main causes of chemotherapy inefficiency in patients with multidrug-resistant pulmonary tuberculosis. Infusion & Chemotherapy, (1), 10-13. https://doi.org/10.32902/2663-0338-2020-1-10-13
Section
ORIGINAL STUDIES

Author Biographies

M. I. Sakhelashvili, Lviv National Medical University named after Danylo Halytsky, Lviv, Ukraine

Sakhelashvili Manana Ivanivna
Professor of the Department of Phthisiology and Pulmonology.
MD.
477, Zelena st., Lviv, 79060, Ukraine.
E‑mail: sakhelashvilimanana@gmail.com

I. L. Platonova, Research Institute of Epidemiology and Hygiene of Danylo Halytsky National Medical University, Lviv, Ukraine

Platonova Iryna Lvivna
Associate Professor, Head of the Laboratory of Molecular and Genetic Methods of Researches
PhD.
12, Zelena st., Lviv, 79005, Ukraine.

O. I. Sakhelashvili-Bil, Lviv Regional Phthisiopulmonological Clinical Treatment and Diagnostic Center, Lviv, Ukraine

Sakhelashvili-Bil Olga Ivanivna
Phthisiologist
477, Zelena st., Lviv, 79060, Ukraine.

T. V. Tlustova, National institute of Рhthisiology and Рulmonology named after F.G. Yanovsky NAMS of Ukraine, Kyiv, Ukraine

Tlustova Tetiana Volodymyrivna
Head of the Department of Diagnostic of Chemically Resistant Forms of Tuberculosis
PhD
10, Amosova st., Kyiv, 03038, Ukraine.