Treatment outcomes among multidrug-resistant TB patients in Bahawal Victoria Hospital, Bahawalpur, Pakistan: a retrospective record review

Abstract

Background This study aims to evaluate the treatment outcomes and factors associated with unsuccessful treatment outcomes among multidrug-resistant TB (MDR-TB) patients. Method This was a retrospective observational study conducted at the Bahawal Victoria Hospital, Bahawalpur, Pakistan. The sociodemographic, clinical and treatment-related data of MDR-TB patients registered at the study site between June 2014 and December 2016 were retrospectively collected. Patients’ treatment outcomes were categorized on the basis of WHO-recommended criteria. Multivariate binary logistic regression analysis was used to find the independent factors associated with unsuccessful treatment outcomes. Results Out of 179 MDR-TB patients, 106 (59.2%) completed their treatment successfully. The remaining 73 patients (40.8%) had unsuccessful treatment outcomes, among whom 45 (25.1%) died, while 18 (10.1%) were lost to follow-up. Factors associated with unsuccessful treatment outcomes included age ≥40 y (AOR 4.310; p = 0.006), unsuccessful interim treatment outcomes (AOR 5.810; p = 0.032), occurrence of adverse events (AOR 0.290; p = 0.029) and ofloxacin resistance (AOR 2.952; p = 0.042). Conclusion The treatment success rate among the selected cohort of MDR-TB patients was less than the target of ≥75% set by the WHO in the End TB Strategy. The lower treatment success rate at the study site requires urgent attention from clinicians and program managers.

Antibiotic stewardship program in Pakistan: a multicenter qualitative study exploring medical doctors’ knowledge, perception and practices

“…Besides the development of MDR bacterial strains, inappropriate use of antibiotics negatively influences patients’ lives by increasing the length of hospitalization and out-of-pocket expenses, and decreasing quality of life of patients. Moreover, it leads to the financial burden on a healthcare systems [ 10 – 16 ]. Antimicrobial Stewardship involves adopting systematic measures to optimize antimicrobial use, decrease unnecessary antimicrobial exposure and to decrease the emergence and spread of resistance.…”

Spectrum of Microorganisms, Antibiotic Resistance Pattern, and Treatment Outcomes Among Patients With Empyema Thoracis: A Descriptive Cross-Sectional Study From the Bahawal Victoria Hospital Bahawalpur, Punjab, Pakistan

“…Data analysis was performed by using Statistical Package for Social Sciences (IBM SPSS statistics for windows version 20.0, Armonk, NY: IBM Corp) (27). Continuous variables were presented as mean and standard deviation (SD), whereas counts (n) and proportions (%) were used to present categorical variables (27).…”

“…This study was conducted in the chest disease unit (CDU) of the Bahawal Victoria hospital (BVH), Bahawalpur, Punjab, Pakistan. This tertiary care hospital has a capacity of over 1,600 beds (27). The CDU serves both indoor and outdoor patients suffering from different forms of lung diseases.…”

“…The CDU serves both indoor and outdoor patients suffering from different forms of lung diseases. The CDU has five to six consultants, 15-18 doctors, two pharmacists and has a bed capacity of 64 (27).…”

“…The patients with empyema thoracis who left the hospital on their own before treatment completion (27).…”