OBJECTIVE: To determine the prevalence of primary and secondary drug resistance to first line
STUDY DESIGN: A hospital-based cross-sectional observational study.
PLACE AND DURATION: Department of Medicine Liaquat University Hospital Hyderabad/ Jamshoro
& Institute of Chest Diseases Kotri from April 2005 to March 2007.
PATIENTS AND METHODS: Fifty cases of Pulmonary tuberculosis (TB) randomly selected from
both institutes who fulfilled the following criteria 1) Sputa showed positive smear for Acid Fast
bacilli on Zeil Nelson Stain.2) Chest x-ray showed shadow consistent with TB. A detailed history,
contact with TB patients, previous use of anti-tuberculous drugs and Chest x-ray was
done. Sputa of all patients were sent for detail report and culture sensitivity. Descriptive and
inferential statistical analysis was performed using SPSS version 14.0.
RESULTS: Among 50 patients, 28(56%) were males and 22(44%) females, age ranged from 16-80
years (38.14 + 15.69). All 50 (100%) patients presented with fever and cough, haemoptysis in 36
(72%), chest pain in 9(18%) and dyspnea in 11(22%) cases, anemia in 39(78%) and lymphadenopathy
in 12(24%). On chest x-ray examination, 19(38%) patients had multiple infiltrations,
cavitations in 10(20%), fibrosis in 9(18%), consolidation in 5(10%), pneumothorax in 4(8%) and
pleural effusion in 3(6%) cases. Sputum for AFB was positive in all cases. Twenty-one (42%)
culture positive patients were of primary resistance and 29(58%) were of secondary resistance.
Twenty (40%) were sensitive to five drugs, 9(18%) resistant to one drug, 11(22%) to two drugs, 7
(14%) to three drugs, 3(6%) to four drugs and none resistant to five drugs.
CONCLUSION: In our setting, the prevalence of resistance to anti-tuberculous drugs is high and
alarming. Strategy should be made for proper treatment and compliance of patients to avoid the
development of drug resistance.
Pulmonary tuberculosis, drug resistance, anti-tuberculous drugs.