Assessing the Effectiveness of a Short Injectable Treatment Regimen for Multidrug-Resistant Tuberculosis: Clinical Outcomes in Khyber Pakhtunkhwa.

Background The currently recommended treatment regimens for multidrug-resistant tuberculosis (MDR-TB) are complex, costly, prolonged (lasting at least 20 months), and often poorly tolerated. The objective of this study was to evaluate the effectiveness of the shorter treatment regimen (STR) for treating patients with MDR-TB in Khyber Pakhtunkhwa. Methodology The present study was a case series conducted at the Programmatic Management of Drug Resistant TB Unit, Lady Reading Hospital (PMDT-LRH), Khyber Pakhtunkhwa, Pakistan. Patients enrolled from December 2017 to November 2020 were included. Eligible patients received a STR for MDR-TB. All patients under five years of age, pregnant women, and those with psychiatric or serious medical illnesses were excluded. At the time of enrollment, all patients were screened with sputum smear, culture, drug susceptibility testing (DST), and chest radiographs. Follow-up evaluations were conducted at regular intervals, sputum smear and culture monthly and chest radiographs bimonthly, throughout the intensive and continuation phases of treatment. Results The mean age of all patients was 34.98 years (SD=17.69). The majority of study participants (n=111, 56.4%) were females. Fifty-nine patients (29.9%) had previously received treatment with first-line anti-tuberculosis medicines. A total of 197 patients were enrolled, but 53 were transferred to a longer treatment regimen (LTR) due to prolonged drug usage or failure to respond to the STR. Therefore, 144 participants were treated further. Of these, 109 (75.8%) had a successful treatment outcome, whereas 35 (24.2%) had an unsuccessful treatment outcome. Adverse drug reactions were reported in 33 of the participants (22.9%). Conclusion A STR for MDR-TB is an effective treatment program as compared to other treatment regimens. However, further studies are necessary to evaluate long-term outcomes or adverse effects on a larger population.