Patterns of Drug Resistance and Treatment Outcomes in Drug-Resistant Tuberculosis Patients in Fuyang City: A Three-Year Retrospective Study

Objective: This study aimed to analyze drug resistance patterns and inpatient medication utilization among drug-resistant tuberculosis (DR-TB) patients in Fuyang City (2021– 2023), and to identify factors associated with unsuccessful treatment outcomes in multidrug-resistant tuberculosis (MDR-TB) patients, to inform outcome-based local prevention and control strategies. Methods: A retrospective analysis was conducted on patients who underwent drug susceptibility testing (DST) for Mycobacterium tuberculosis at the Second People’s Hospital of Fuyang City from January 2021 to December 2023. Patients with resistance to any first-line anti-tuberculosis drug were included. Chi-square tests were used to compare drug resistance and medication utilization between initial and retreatment cases. Binary logistic regression identified factors associated with MDR-TB treatment outcomes. A p -value < 0.05 was considered statistically significant. Results: Among 181 DR-TB patients, 120 were initial treatment and 61 retreatment cases. MDR-TB accounted for the highest proportion (40.88%, 74/181). Ethambutol showed the highest resistance prevalence (69.61%), followed by isoniazid (64.64%), rifampicin (51.38%), and streptomycin (33.70%). First-line drugs were used significantly more frequently in initial treatment than retreatment patients ( p < 0.05). Annual increases were observed in the use of cycloserine, bedaquiline, linezolid, and clofazimine ( p < 0.05). The treatment success rate among MDR-TB patients was 55.41%. Multivariate logistic regression identified retreatment as an independent risk factor for unfavorable outcomes (OR = 4.524, 95% CI: 1.174– 17.435, p = 0.028), while a bedaquiline-containing regimen was a protective factor (OR = 0.155, 95% CI: 0.033– 0.721, p = 0.017). Among the 31 patients receiving bedaquiline-containing regimens, 19 received long-course and 12 short-course treatment. Conclusion: DR-TB remains a significant burden in Fuyang City, with high first-line drug resistance rates, a high proportion of MDR-TB exhibiting complex resistance profiles, and suboptimal treatment success. Bedaquiline-containing regimens are protective against poor outcomes. Keywords: drug-resistant tuberculosis, first-line drugs, retreatment, multidrug-resistant tuberculosis, bedaquiline