[Drug resistance in recurrent cases of tuberculosis].

PURPOSE Investigate drug resistant rate in recurrent cases after cure, or after drop-out from treatment, and the analysis of the risk factors for acquired drug resistance in these cases. OBJECT Patients who were previously treated for tuberculosis that was drug sensitive or unknown about previous drug sensitivity, and were hospitalized to Fukujuji Hospital to start treatment for recurrent tuberculosis from Jan. 1, 1993 to Dec. 31, 2003. Primary drug resistant cases were excluded and cases were further divided into full sensitive cases and cases with drug sensitivity test results were unknown. METHOD Chart review. RESULT Drug resistant rate (any resistance to INH, RFP, SM, EB) in all recurrent cases (N=200) was 16.5%. Availability of previous drug sensitivity results affected on the drug resistant rate in recurrent cases. In previously pan-sensitive cases, drug resistant rate was 4.3% and it was lower than the rate in primary treated cases. No significant risk factor for acquired drug resistance was not found, including poor adherence to medication. CONCLUSION Every effort should be made to know the previous drug sensitivity results because these results have a major impact on drug resistance rate at recurrence. Doctor's mismanagements of tuberculosis patients might be the major factor for acquired drug resistance in recurrent cases, and it is needed for the improvement of tuberculosis control program to implement the measures to control these mismanagements.