CLINICAL FEATURES AND EFFECTIVENESS OF THE COMPLEX TREATMENT FOR EXTENSIVELY DRUG RESISTANT PULMONARY TB IN DIFFERENT GROUPS OF PATIENTS
The epidemic situation of tuberculosis (TB) is improving in Russia. However, major risks for the adverse scenario depend on the share of cases with multi- or extensively drug resistant TB (MDR/XDR-TB). New chemotherapy regimens are not enough for treatment success. It is necessary to introduce the complex approach involving chemotherapy along with high-tech surgical methods and collapse therapy to cope with the situation. We analyzed effectiveness of the complex treatment of 281 XDR-TB patients with different case histories. We described the clinical course and drug resistance spectra and studied the share and effectiveness of collapse therapy and surgery in different XDR-TB cases. Sputum conversion by the eighth month of inpatient treatment was as follows: 83.7% - in new cases, 76.1% - in retreatment cases, and 77.4% - in relapse cases. By the same time cavity closure was observed in 71.1%, 55.1%, and 60.0% of the above groups of cases respectively. Our study enables to optimize approaches to effective treatment of drug resistant TB cases.