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The Treatment of Isoniazid Resistant Tuberculosis with Predominantly a Nine-Month Regimen

Sarah A Haines, Rahul Mittal and Lawrence Peter Ormerod

Background: Chest Clinic in Blackburn UK, a high Tuberculosis (TB) incidence area of the United Kingdom.

Methods: Retrospective analysis of a prospectively compiled database of TB notifications. The clinical characteristics and management of those cases with isonazid resistance (with or without additional streptomycin resistance) for the years 1989-2008 inclusive is described.

Results: 36 patients with proven and 3 with presumed isoniazid resistance were treated, 15 with pulmonary and 21 with non-pulmonary confirmed cultures. 35 patients (92%) were treated with a regimen of nine months rifampicin and ethambutol, supplemented by two months initial pyrazinamide (2RZE/7RE). No clinical or bacteriological relapses occurred.

Conclusion: This retrospective cohort study with a minimum of 12 months post treatment follow-up of all cases shows that a nine-month regimen, 2RZE/7RE with careful monitoring can be associated with satisfactory results in the treatment of isoniazid-resistant TB.