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Extension of the intensive phase reduces unfavourable outcomes with the 8-month thioacetazone regimen

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Show simple item record Van Deun, A. en_US Aung, K. J. M. en_US Hamid Salim, A. en_US Ali, M. A. en_US Naha, M. S. en_US Das, P. K. en_US Hossain, M. A. en_US Declercq, E. en_US 2007-12-06T14:48:34Z 2007-12-06T14:48:34Z 2006 en_US
dc.identifier.issn 1027-3719 en_US
dc.identifier.other ITG-M1A en_US
dc.identifier.other MICRO en_US
dc.identifier.other U-MYCOB en_US
dc.identifier.other JIF en_US
dc.identifier.other ABSTRACT en_US
dc.description.abstract SETTING: Damien Foundation tuberculosis (TB) control projects in Bangladesh. OBJECTIVE: To assess the effectiveness of a 1-month extension of the intensive phase for smear-positives at 2 months of an 8-month regimen with a continuation phase consisting of isoniazid (INH) and thioacetazone (Th). DESIGN: A prospective study of two cohorts of newly registered smear-positive cases, with extension of the intensive phase for the control cohort, but not for the study cohort. Culture and drug susceptibility testing (DST) of smear-defined failures and relapses and of random samples of new cases. RESULTS: Among 8230 study patients (86.7% 2-month conversion) and 7206 controls (83.4% conversion), smear-defined failure or relapse outcome was 3.0% for 2-month smear-negatives vs. 3.1% for 2-month smear-positives with extension (non-significant, NS), and 8.2% for 2-month smear-positives with no extension (P < 0.00001). Culture-confirmed failure and relapse reached 1.9% in 2-month smear-negatives and 1.6% (NS) in 2-month smear-positives with vs. 3.7% (P < 0.001) in 2-month smear-positives with no extension. The relative risk (RR) of non-extension in 2-month smear-positives was 2.4 (cultures) to 2.7 (smears). The same RR and borderline significance was found for non-extension of patients with pan-susceptible strains. CONCLUSIONS: Extension of the intensive phase considerably reduces failures and relapses with a weaker regimen in patients smear-positive at 2 months. Its effectiveness may vary with extent of initial drug resistance vs. power of the regimen. en_US
dc.language English en_US
dc.publisher International Union Against Tuberculosis And Lung Disease
dc.subject Bacterial diseases en_US
dc.subject Tuberculosis en_US
dc.subject Drug therapy en_US
dc.subject Antimicrobial agents en_US
dc.subject Thioacetazone en_US
dc.subject Regimens en_US
dc.subject Treatment failure en_US
dc.title Extension of the intensive phase reduces unfavourable outcomes with the 8-month thioacetazone regimen en_US
dc.type Article en_US
dc.citation.issue 11 en_US
dc.citation.jtitle International Journal of Tuberculosis and Lung Disease en_US
dc.citation.volume 10 en_US
dc.citation.pages 1255-1261 en_US Paris
dc.citation.jabbreviation Int J Tuberc Lung Dis en_US

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