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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To determine if isoniazid-and&#47;or rifampicin-free antituberculosis treatment regimens are safe and effective and to identify any factors that might require changes in the regimens&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">We carried out a retrospective study of patients treated with isoniazid-and&#47;or rifampicin-free regimens between 1995 and 2005 at 2 specialized hospitals in Barcelona&#44; Spain&#46; Predictive factors were studied by logistic regression and the odds ratio&#59; 95&#37; confidence intervals were calculated&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Eighty-five patients were included in the study&#58; 35&#37; were immigrants and 34&#37; were infected with human immunodeficiency virus&#46; The reason for omitting isoniazid or rifampicin was toxicity &#40;53&#37;&#41;&#44; followed by multidrug resistance &#40;39&#37;&#41;&#46; Rifampicin-free regimens were most common &#40;42&#37;&#41;&#46; A change in the isoniazid-and&#47;or rifampicin-free regimen was required in 30&#37; of cases&#44; but was not associated with being an immigrant&#46; The rate of toxicity with these regimens was higher &#40;36&#37;&#41;&#44; although progress was always satisfactory&#46; Clinical course was satisfactory in 77&#37; of patients and they were discharged&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Isoniazid-and&#47;or rifampicin-free regimens with adequate follow-up showed similar treatment outcomes compared with standardized treatment regimens&#46; Although these regimens were more toxic&#44; patient progress was good&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Determinar si las pautas de tratamiento antituberculoso sin isoniacida y&#47;o rifampicina &#40;PsHR&#41; son efectivas y seguras&#44; y conocer los factores que obligan a cambiarlas&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio retrospectivo de los pacientes tratados con PsHR entre 1995 y 2005 en 2 centros especializados de Barcelona&#46; Los factores predictores se estudiaron mediante regresi&#243;n log&#237;stica&#44; calcul&#225;ndose las <span class="elsevierStyleItalic">odds ratio</span> y sus intervalos de confianza del 95&#37;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; en el estudio a 85 pacientes&#46; Un 35&#37; eran inmigrantes y un 34&#37; estaban infectados por el virus de la inmunodeficiencia humana&#46; La causa de no administrar isoniacida y&#47;o rifampicina fue sobre todo la toxicidad &#40;53&#37;&#41;&#44; seguida de resistencia a f&#225;rmacos antituberculosos &#40;39&#37;&#41;&#46; Las pautas sin rifampicina fueron las m&#225;s frecuentes &#40;42&#37;&#41;&#46; Fue preciso cambiar la PsHR en el 30&#37; de los casos y esto se asoci&#243; a no ser inmigrante&#46; La toxicidad de las pautas fue m&#225;s elevada &#40;36&#37;&#41;&#44; aunque su evoluci&#243;n fue siempre favorable&#46; El 77&#37; de los pacientes tuvo una evoluci&#243;n satisfactoria y fue dado de alta&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Las PsHR&#44; con un buen seguimiento&#44; poseen una efectividad similar a las pautas est&#225;ndar y&#44; aunque su toxicidad es m&#225;s elevada&#44; &#233;sta sigue una evoluci&#243;n correcta&#46;</p>"
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Vol. 44. Issue 9.
Pages 478-483 (January 2008)
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Vol. 44. Issue 9.
Pages 478-483 (January 2008)
Original Articles
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Effectiveness and Tolerance of Antituberculosis Treatment Regimens Without Isoniazid and Rifampicin: Analysis of 85 Cases
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José R. Tosta,b, Rafael Vidalc,
Corresponding author
ravidal@vhebron.net

Correspondence: Dr R. Vidal Servicio de Neumología, Hospital Universitario Vall d'Hebron Pg. Vall d'Hebron, 119-129 08035 Barcelona, Spain
, José Maldonadod, Joan A. Caylàe
a Servicio de Urgencias, Hospital de Terrassa, Terrassa, Barcelona, Spain
b Servicio de Neumología, CIBERES, Hospital Universitario Vall d'Hebron, Barcelona, Spain
c Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, Spain
d Serveis Clínics, Barcelona, Spain
e Agència de Salut Pública de Barcelona, Barcelona, Spain
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Objective

To determine if isoniazid-and/or rifampicin-free antituberculosis treatment regimens are safe and effective and to identify any factors that might require changes in the regimens.

Patients and methods

We carried out a retrospective study of patients treated with isoniazid-and/or rifampicin-free regimens between 1995 and 2005 at 2 specialized hospitals in Barcelona, Spain. Predictive factors were studied by logistic regression and the odds ratio; 95% confidence intervals were calculated.

Results

Eighty-five patients were included in the study: 35% were immigrants and 34% were infected with human immunodeficiency virus. The reason for omitting isoniazid or rifampicin was toxicity (53%), followed by multidrug resistance (39%). Rifampicin-free regimens were most common (42%). A change in the isoniazid-and/or rifampicin-free regimen was required in 30% of cases, but was not associated with being an immigrant. The rate of toxicity with these regimens was higher (36%), although progress was always satisfactory. Clinical course was satisfactory in 77% of patients and they were discharged.

Conclusions

Isoniazid-and/or rifampicin-free regimens with adequate follow-up showed similar treatment outcomes compared with standardized treatment regimens. Although these regimens were more toxic, patient progress was good.

Key words:
Antituberculosis drugs
Tuberculosis
Drug resistance
Drug toxicity
Mycobacterium tuberculosis
Objetivo

Determinar si las pautas de tratamiento antituberculoso sin isoniacida y/o rifampicina (PsHR) son efectivas y seguras, y conocer los factores que obligan a cambiarlas.

Pacientes y métodos

Se ha realizado un estudio retrospectivo de los pacientes tratados con PsHR entre 1995 y 2005 en 2 centros especializados de Barcelona. Los factores predictores se estudiaron mediante regresión logística, calculándose las odds ratio y sus intervalos de confianza del 95%.

Resultados

Se incluyó en el estudio a 85 pacientes. Un 35% eran inmigrantes y un 34% estaban infectados por el virus de la inmunodeficiencia humana. La causa de no administrar isoniacida y/o rifampicina fue sobre todo la toxicidad (53%), seguida de resistencia a fármacos antituberculosos (39%). Las pautas sin rifampicina fueron las más frecuentes (42%). Fue preciso cambiar la PsHR en el 30% de los casos y esto se asoció a no ser inmigrante. La toxicidad de las pautas fue más elevada (36%), aunque su evolución fue siempre favorable. El 77% de los pacientes tuvo una evolución satisfactoria y fue dado de alta.

Conclusiones

Las PsHR, con un buen seguimiento, poseen una efectividad similar a las pautas estándar y, aunque su toxicidad es más elevada, ésta sigue una evolución correcta.

Palabras clave:
Fármacos antituberculosos
Tuberculosis
Resistencia a fármacos
Toxicidad farmacológica
Mycobacterium tuberculosis
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This study was funded in part by a grant from the Catalan Society de Pneumology (SOCAP) in 2006 for the Development of Pulmonology Research.

Copyright © 2008. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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