Multidrug-resistant tuberculosis: long-term treatment outcome in the Netherlands

Int J Tuberc Lung Dis. 2000 Aug;4(8):758-64.


Setting: Tuberculosis units (Beatrixoord, Haren; and Dekkerswald, Groesbeek) in the Netherlands.

Objective: To study the long-term treatment outcome of patients with multidrug-resistant tuberculosis (MDR-TB).

Design: Descriptive analysis of all consecutively admitted patients with MDR-TB between 1 January 1985 and 1 September 1998, with follow-up until 1 August 1999.

Results: Of 44 patients (31 male) enrolled in the study, 33 were foreign born and none were human immunodeficiency virus positive. At diagnosis 38 patients had sputum-smear positive pulmonary TB, and converted culture negative after a mean of 6 weeks, while six converted to negative later (mean 69 weeks). Most patients had micro-organisms resistant to several antimycobacterial drugs (mean = median: 5), including resistance to isoniazid and rifampin. In-patient treatment lasted a mean of 164 days (range 31-481), and patients were treated with six drugs on average. Side effects were common. Treatment lasted for a mean of 608 days (range 268-1626); five patients are still on treatment. Four patients were operated for TB, and two others were operated for post-TB sequelae. During the follow-up period six patients died, of whom three had active TB; 33 (75%) were considered cured.

Conclusion: Mortality was only 14% after a mean follow-up period of 53 months. MDR-TB can be successfully treated, but requires much effort from both patients and carers, and the costs may be higher than is affordable in resource-poor countries.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents / adverse effects
  • Antitubercular Agents / therapeutic use*
  • Child
  • Costs and Cost Analysis
  • Female
  • Follow-Up Studies
  • Humans
  • Isoniazid / adverse effects
  • Isoniazid / therapeutic use
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Rifampin / adverse effects
  • Rifampin / therapeutic use
  • Sputum / microbiology
  • Survival Analysis
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Tuberculosis, Multidrug-Resistant / mortality


  • Antitubercular Agents
  • Isoniazid
  • Rifampin