Background: Tuberculosis (TB) is an infectious disease caused by mycobacterium tuberculosis with a high incidence rate in India. In recent times, reducing the emergence of multi drug resistant TB (MDR-TB) poses a great challenge. Aims and objectives: To study the 3rd & 6th month sputum culture status, after starting Category IV regimen and factors responsible for culture conversion of MDR-TB patients. Material and Methods: We enrolled a total of 200 patients. Out of these, 3 patients were baseline XDR-TB, so excluded and 176 patients completed the study. All MDR/rifampicin resistant pulmonary TB patients >14 years of age receiving category IV regimen & willing to give consent for participation were included in the study. Patients with extrapulmonary TB were excluded. Majority of the patients (89.20%) patients remained negative at 3rd and 6th month. Results: We found a significant association between delayed culture conversion and former smokers with >20 pack year smoking history compared to early convertors with persistent culture negative at 6 months. At baseline, fluoroquinolone resistance was independently found to be significantly associated with adverse effect on culture conversion in the first 6 months. Also, there was significant association (p = 0.02) in patients showing culture positivity at 6th month following early negative cultures and current alcohol intake (within the last 6months) as well as with HIV positivity and cough > 2month. Female gender, conversion of sputum culture from positive to negative and radiological improvement was found to be positive predictors of a successful treatment outcome. While smoking habit and alcohol consumption was negative predictors of successful treatment outcome. Thirty five (26%) patients developed ADRs that required withdrawal of causal drug. Conclusion: This study presented with the various factors associated with early and delayed culture conversion and culture reversion of MDR-TB patients.

Background: Tuberculosis (TB) is an infectious disease caused by mycobacterium tuberculosis with a high incidence rate in India. In recent times, reducing the emergence of multi drug resistant TB (MDR-TB) poses a great challenge. Aims and objectives: To study the 3rd & 6th month sputum culture status, after starting Category IV regimen and factors responsible for culture conversion of MDR-TB patients. Material and Methods: We enrolled a total of 200 patients. Out of these, 3 patients were baseline XDR-TB, so excluded and 176 patients completed the study. All MDR/rifampicin resistant pulmonary TB patients >14 years of age receiving category IV regimen & willing to give consent for participation were included in the study. Patients with extrapulmonary TB were excluded. Majority of the patients (89.20%) patients remained negative at 3rd and 6th month. Results: We found a significant association between delayed culture conversion and former smokers with >20 pack year smoking history compared to early convertors with persistent culture negative at 6 months. At baseline, fluoroquinolone resistance was independently found to be significantly associated with adverse effect on culture conversion in the first 6 months. Also, there was significant association (p = 0.02) in patients showing culture positivity at 6th month following early negative cultures and current alcohol intake (within the last 6months) as well as with HIV positivity and cough > 2month. Female gender, conversion of sputum culture from positive to negative and radiological improvement was found to be positive predictors of a successful treatment outcome. While smoking habit and alcohol consumption was negative predictors of successful treatment outcome. Thirty five (26%) patients developed ADRs that required withdrawal of causal drug. Conclusion: This study presented with the various factors associated with early and delayed culture conversion and culture reversion of MDR-TB patients.