Initial Drug Resistance and Tuberculosis Treatment Outcomes: Systematic Review and Meta-analysis

Data Synthesis: Pooled cumulative incidences were computed with random-effects meta-analyses. Association between risk factors and outcomes were determined by using stratified analyses. The cumulative incidence of acquired drug resistance with initially pan-sensitive strains was 0.8% (95% CI, 0.5% to 1.0%) compared with 6% (CI, 4% to 8%) with initially single drug–resistant strains and 14% (CI, 9% to 20%) with initially polydrug-resistant strains. Failure and relapse were most strongly associated with initial drug resistance. Failure was also associated with shorter duration of rifampin therapy and nonuse of streptomycin, whereas the rate of relapse was higher with shorter duration of rifampin therapy and nonuse of pyrazinamide
::::::Annals Intern Med 15 July 2008 Volume 149 Issue 2 Pages 123-134