OPTIMIZATION OF TREATMENT FOR PATIENTS WITH DRUG-RESISTANT PULMONARY TUBERCULOSIS
Abstract
Relevance.Drug-resistant pulmonary tuberculosis (DR-TB) remains one of the most serious threats to public health, particularly in resource-limited and transitional economies. Resistance of Mycobacterium tuberculosis to key anti-tuberculosis drugs such as isoniazid and rifampicin significantly reduces the effectiveness of standard treatment regimens, which are often lengthy, toxic, and associated with low patient adherence. This underscores the importance of evaluating the effectiveness of short, individualized regimens incorporating newer-generation drugs. This study aimed to compare the clinical efficacy and tolerability of traditional long-term versus short individualized treatment regimens for DR-TB in Uzbekistan. Materials and methods of the study .A retrospective analysis was conducted on 120 patient medical records from the Republican Tuberculosis Dispensary between 2020 and 2023. Patients were divided into two groups: 65 patients received short-term individualized regimens (6–9 months) including bedaquiline, delamanid, and linezolid, while 55 patients were treated with standard regimens (18–20 months). Evaluation criteria included bacteriological conversion time, relapse rates, incidence of moderate/severe adverse effects, and treatment adherence. Research results.Short regimens showed superiority across all measured indicators: average time to bacteriological conversion was 16 weeks (vs. 28 in the control group), relapse rate within 12 months was 7% (vs. 15%), incidence of adverse effects was 26% (vs. 42%), and treatment adherence reached 89% (compared to 64% in the standard group). All differences were statistically significant (p < 0.05). Conclusion. The findings confirm the high clinical and epidemiological effectiveness of short individualized regimens for DR-TB. Their implementation can significantly improve treatment quality, increase patient adherence, reduce the risk of resistant strain transmission, and lower the burden on healthcare systems. Given these advantages, it is advisable to integrate these regimens into the updated national tuberculosis treatment protocols in Uzbekistan.
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