Effectiveness of Different Treatment Regimens for Patients with Newly Diagnosed Pulmonary Tuberculosis Susceptible to Antituberculosis Drugs

Development of new, more effective methods of tuberculosis treatment is one of the priority areas of modern phthisiology. In recent years, antibacterial drugs of the fluoroquinolone series have begun to be widely used in the treatment of not only resistant, but also drug-susceptible tuberculosis. Objective — to evaluate the effectiveness of a 4-month chemotherapy regimen for newly diagnosed sensitive pulmonary tuberculosis, which includes moxifloxacin and rifapentine. Materials and methods. To achieve the goal, 65 patients with newly diagnosed drug-susceptible pulmonary tuberculosis were selected. 33 patients (main group) were treated with a 4-month regimen that included moxifloxacin and rifapentine in the intensive and continuation phases of treatment: 2HPZMfx 2HPMfx. 32 patients in the control group were treated with a standard 6-month regimen: 2HREZ 4HR. The average age of patients in the main group was 45.3 ± 1.3, in the control group — (44.8 ± 1.2; p > 0.05) years, in both groups people from 35 to 55 years prevailed. There were 24 men in the main group (72.73 %), 9 women (27.27 %), respectively in the control group — 23 (71.88 %) and 9 (28.12 %). Patients in both groups were identical in age, sex, clinical forms of pulmonary tuberculosis, the presence of bacterial excretion and comorbid conditions. Results and discussion. Analysis of the data obtained showed that the cessation of bacterial excretion occurred in all (33; 100 %) patients in the main group and in 30 (93.75 %) patients in the control group. Radiological changes in the lung tissue after the completion of the treatment course completely disappeared in 29 (87.88 %) patients of the main group and 27 (84.38 %) of the control group, and in another 2 (6.06 %) and 3 (9.37 %) patients, respectively, pathological changes in the lungs decreased. In 17 (51.5 %) of the main group and 14 (43.75 %) of the control group, after the completion of the treatment, body weight increased by an average of 2—3 kg. All patients (33, 100 %) of the main group after the completion of the full course of treatment recovered clinically and their signs of the disease disappeared. In the control group, this figure was 93.75 % (30 patients). In 2 patients, the treatment failed and, accordingly, their clinical condition did not improve. Five patients (15.5 %) of the main group, who did not have concomitant pathology (HIV/AIDS, hepatitis), had adverse reactions to antituberculosis drugs, which manifested themselves in varying degrees of severity. In the control group, no adverse reactions were observed. Conclusions. The results obtained showed high effectiveness of a 4-month treatment regimen for newly diagnosed drug-susceptible pulmonary tuberculosis using moxifloxacin and rifapentine in the intensive and continuation phases of treatment. A shorter treatment period has a positive effect on the patient’s psychological state, facilitates drug intake control, but more often leads to adverse reactions and is 45.44 % (3473.6 UAH) more expensive.