Timothy H. Holtz, MD, MPH; Maya Sternberg, PhD; Steve Kammerer, MBA; Kayla F. Laserson, ScD; Vija Riekstina, MD; Evija Zarovska, MD; Vija Skripconoka, MD; Charles D. Wells, MD; Vaira Leimane, MD
Holtz TH, Sternberg M, Kammerer S, Laserson KF, Riekstina V, Zarovska E, et al. Time to Sputum Culture Conversion in Multidrug-Resistant Tuberculosis: Predictors and Relationship to Treatment Outcome. Ann Intern Med. 2006;144:650-659. doi: 10.7326/0003-4819-144-9-200605020-00008
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Published: Ann Intern Med. 2006;144(9):650-659.
The accepted method for monitoring treatment of multidrug-resistant pulmonary tuberculosis is periodic sputum culture. The predictors of culture conversion to negative and their relation to final treatment outcome are not known.
Seventy-seven percent of 167 Latvian patients who were receiving DOTS for multidrug-resistant pulmonary tuberculosis had conversion to negative cultures (median time, 8 weeks). Predictors of a longer conversion time were history of treatment for multidrug-resistant tuberculosis, bilateral cavitations, and high colony count on initial sputum cultures. The final outcome was better when sputum conversion occurred within 2 months.
For multidrug-resistant pulmonary tuberculosis, DOTS can be successful in most patients.
Thirty-eight of 167 patients who were sputum culture–positive at treatment initiation did not have conversion.
The value reflects the results of the log-rank test of the equality of the 3 survival curves. TB = tuberculosis.
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Infectious Disease, Mycobacterial Infections, Prevention/Screening.
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