Effectiveness of anti-tuberculosis chemotherapy in patients with tuberculosis relapse compared with newly diagnosed patients

Abstract

Aim. To study the effectiveness of anti-tuberculosis chemotherapy in patients with recurrent pulmonary tuberculosis (RTB) compared with patients with the newly diagnosed process. Materials and methods. We examined 285 TB patients, including 126 individuals with RTB (group 1) and 159 patients with newly diagnosed pulmonary tuberculosis (NDPTB) (group 2). All patients were diagnosed with infiltrative pulmonary tuberculosis (TB). Effectiveness of the basic course of antimicobacterial treatment was assessed in accordance with the following data: time required for the normalization of clinical manifestations, smear conversion, cavity healing, disappearance of infiltrative and focal changes in the pulmonary tissue, as well as the final clinical effectiveness of therapy. Results. Disappearance of clinical symptoms was significantly faster in group 2 compared with RTB patients in (2.25±0.11) and (3.40±0.15) months, respectively (p<0.001). Sputum culture conversion was observed after 6 months of treatment in 138 (86.79%) patients with NDPTB and 89 (72.22%) patients from group 1 (p=0.0023). Closure of cavities and disappearance of infiltrative and focal changes in the lungs occurred within 6 months of chemotherapy only in 55 (43.65%) patients with RTB and 93 (58.49%) patients with NDPTB (p=0.0133). Conclusions. Standard treatment for patients with NDPTB is considered successful in case of faster health improvement and stabilization, less pronounced rates of toxic adverse reactions to anti-TB drugs, faster sputum smear and culture conversion and cavity healing, signs of clinical and radiological convalescence, and the reduced number of large residual changes after the treatment compared with RTB.