Is it worth treating category I failure patients with category II regimen

Abstract

Background: Very little information is available on the drug susceptibility profile among patients who are treated with
\nstandardized short-course chemotherapy regimens under programme conditions.
\nMethods: Sputum samples were collected from new sputum smear-positive patients declared ‘failure’ after treatment with
\nCategory I regimen under tuberculosis control programme using DOTS strategy from a rural area of Tamil Nadu.
\nResults: Of 1463 patients started on Category I regimen between May1999 and December 2002, 74 cases were declared
\nas ‘failures’ (smear positive at 5/6 months of treatment). We collected sputum samples from 60 (81%) of 74 ‘failures’ and
\n27% (16 of 60) of them were culture-negative for M tuberculosis and 17% (10 of 60) had organisms resistant to Isoniazid
\nand Rifampicin (MDR TB).
\nConclusion: Based on the drug susceptibility profile at the time of ‘failure’, treating Category I ‘failures’ with Category
\nII regimen with close monitoring appears to be justified.