Abstract

Multidrug-resistant tuberculosis (MDR-TB) remains a global health challenge. Short-term regimens using second-line anti-tuberculosis drugs (SLDs) show promise for improved outcomes, but real-world data from high-burden countries are limited. This study aimed to evaluate the effectiveness and safety of short-term SLD regimens in MDR-TB patients at a national referral center in Indonesia. A retrospective observational cohort study was conducted among MDR-TB patients aged >14 years who received short-term therapy (≥6 months) at the Dr. Hasan Sadikin General Hospital outpatient clinic from July 2023 to December 2024. Data were extracted from medical records and the Tuberculosis Information System. The primary outcomes were treatment success (cured or treatment completed) according to World Health Organization definitions, and adverse events (AEs) were documented and graded. Statistical analyses included descriptive statistics, multinomial logistic regression, Spearman correlation, and non-parametric tests. Among 72 patients screened, 54 met the inclusion criteria. Treatment success was achieved in 74.08% (40/54) of patients: 40 were cured, 7 died, and 7 failed due to diagnostic changes. The median time to sputum culture conversion was 6 months (interquartile range 2–6). Gastrointestinal AEs were most common (56.38%), primarily nausea (36.17%). Musculoskeletal/neurological events occurred in 12.76%, and cardiac events occurred in 5.31%. No significant associations were found between demographic characteristics and treatment outcomes or total AEs. Short-term SLD regimens demonstrated good effectiveness (74.08% success) with manageable AEs, supporting their use in resource-limited settings with active drug safety monitoring.

Key words: Multidrug-resistant tuberculosis; Short-term regimen; Treatment outcomes; Adverse events; Bedaquiline; Indonesia