Pulmonary tuberculosis with multidrug resistance in its pathogen to essential and reserve drugs

The course of destructive pulmonary tuberculosis and the efficiency of its treatment were studied in 249 patients with this condition who excreted Mycobacterium tuberculosis (MBT) resistant to at least isoniazid and rifampicin in combination with essential and reserve antituberculous drugs (ATD). The investigators identified 2 groups of patients with multidrug resistance (MDR) to a combination of essential ATD (isoniazid and rifampicin with pyrazinamide, ethambutol, and streptomycin) and extensive drug resistance (EDR) to a combination of essential (isoniazid and rifampicin) and reserve (prothionamide, canamycin, capreomycin, cyclosein, and fluoroquinolones) drugs. The chronic course of the disease with severe clinical manifestations and more common infiltrative-destructive lesions of the lung was more frequently noted in patients with EDR in MBT to a combination of essential and reserve drugs. The chemotherapy using a combination of reserve drugs proved to be effective only in patients with MDR in MBT to a combination of essential drugs while in EDR these regimens were little effective or ineffective.