Lytvynenko N. Antimycobacterial therapy of the patients with multi-resistant pulmonary tuberculosis with new and previously treated cases of disease

Object of research – multi or extensively drug resistant lung tuberculosis; the aim: to improve antimycobacterial therapy of the patients with multi-resistant pulmonary tuberculosis with new and previously treated cases of disease by development of a step-by-step algorithm of differentiated appointment of its various regimens; research methods: clinical and laboratory, X-ray, microbiological (detection of MTB by microscopy and culture methods, drug-sensitivity test for anti-TB drugs I and II lines, MG GeneXpert MTB Rif method), statistical; novelty: the frequency of primary resistance among patients with MRTB to aminoglycosides, polypeptides or fluoroquinolones were established; an unfavorable trend the increasing level of the extensively drug resistance or individual resistance to fluoroquinolones was determined; the scientific data on the main factors for the prognosis of the treatment outcome and indications for the palliative care were supplemented and for the first time were systematized; were determined the treatment outcome in patients with the same profile of resistance were different depending on the history of previous treatment and adherence to it; for the first time, an assessment was made of the feasibility of including different anti-mycobacterial agents in the regimen, including - their step-by-step use; the first developed regimens of antimycobacterial therapy, different in composition, duration and, mainly, step-by-step use of combinations of different drugs; the algorithms of the differentiated appointment of these regimes have been developed based on the establishment of the forecast for the treatment.