Drug Resistance Patterns & Treatment Outcomes among Patients Enrolled for MDR-TB Treatment under PMDT at a Tertiary Care Teaching Hospital in Swat.
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Abstract
Objective: To evaluate drug resistance patterns and treatment outcomes among patients with Multidrug‑Resistant Tu-berculosis (MDR‑TB) enrolled in the Programme for Management of Drug‑Resistant Tuberculosis (PMDT) at Saidu Teaching Hospital, Swat, Pakistan. A secondary objective was to identify determinants of poor treatment outcomes and to assess the impact of fluoroquinolone resistance.
Methodology: This retrospective cohort study included 166 MDR-TB patients enrolled between May 21, 2014, and Feb-ruary 6, 2020. Patient data were obtained from medical records, and drug resistance was determined using phenotypic drug susceptibility testing. Treatment outcomes were categorised as cure, failure, death, lost follow-up, or transfer out. Chi-square tests were performed to assess associations between drug resistance and treatment outcomes.
Results: Of the 166 patients, 130 (78.3%) were cured, 15 (9%) died, 13 (7.8%) were lost to follow-up, and 2 (1.2%) failed treatment. Rifampicin (n=50, 30.1%) and Isoniazid (n=52, 31.3%) showed the highest resistance rates. Fifteen percent of the patients (n=25) were found to be resistant to fluoroquinolones. The resistance to rifampicin had a signifi-cant impact on the treatment results (p < 0.00001), whereas the resistance to fluoroquinolone also had a strong effect (p < 0.00001).
Conclusion: This study highlights the critical issue of drug resistance among MDR‑TB patients in Swat, particularly to rifampicin, isoniazid, and fluoroquinolones. The findings underscore the urgent need for improved diagnostic strategies, stronger medication adherence, and enhanced healthcare services, especially in rural areas. Larger multicentre investi-gations are warranted to validate these results and to strengthen local treatment approaches.
Keywords: Multidrug-resistant tuberculosis, drug resistance, treatment outcomes, fluoroquinolone resistance, Pakistan.
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