Clinical Profile and Treatment Evaluation of Rifampicin-Resistant and Multidrug-Resistant Tuberculosis Patients at Dr. Kanujoso Djatiwibowo Public Hospital, Balikpapan

Randy Adiwinata, Josephine Rasidi, Maurits Marpaung


Background: Rifampicin-resistant (RR-TB) and multidrug-resistant tuberculosis (MDR-TB) remains a major health problem worldwide and
in Indonesia also become a challenge in total eradication of tuberculosis. Dr. Kanujoso Djatiwibowo Public Hospital (RSKD) Balikpapan
is one of the two referral hospitals in East Kalimantan for evaluation and initiation of MDR-TB treatment. The objective of this study is to
evaluate clinical profile and treatment of RR-TB and MDR-TB patients at RSKD.
Methods: A retrospective cross-sectional study was conducted using data from eTB manager database and medical record of RR-TB and
MDR-TB at RSKD from January 2013 to October 2016.
Results: Twenty eight RR-TB and MDR-TB patients, most of them were female (53.6%), belong to 35-44 age group (28.6%), housewife
(25%), graduated from senior high school (42,9%), malnutrition (28.6%), and relapse cases (50%). Diabetes mellitus and anemia were
found in 42,9% and 44.4% of the patients, respectively. The most resistant pattern is rifampicin-resistant TB (57,1%) followed by rifampicin
and isoniazid resistant. The most common side effect of TB treatment was gastrointestinal complaints (44.4%). The success rate of MDRTB
treatment at RSKD was 20%, followed by 20% mortality, 50% of lost to follow up, 10% of treatment failure, and there are 8 patients still
ongoing therapy.
Conclusion: Most of the RR-TB and MDR-TB cases were relapse cases. Counseling, education, and support for the patients undergoing MDR-TB
treatment are strongly needed to increase success rate and decreasing number of lost to follow up.


Multidrug-resistant tuberculosis; Rifampicin-resistant; Clinical profile; PMDT; MTPRO

Full Text:



World Health Organization. Global tuberculosis report. [Online]. 2016 [Cited 2016 November 1]. Available from:

World Health Organization. Global tuberculosis report. [Online]. 2014 [Cited 2016 November 1]. Available from:

Kementerian Kesehatan Republik Indonesia. Info datin tuberkulosis. [Online]. 2015 [Cited 2016 November 2]. Available from:

World Health Organization. WHO treatment guidelines for drug-resistant tuberculosis. [Online]. 2016 [Cited 2016 November 1]. Available from:

Kementerian Kesehatan Republik Indonesia Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan. Pedoman nasional

pengendalian tuberkulosis. [Online]. 2014 [Cited 2016 November 1]. Available from:

Sinaga BYM. Karakteristik pasien multi drug resistant tuberculosis yang mengikuti programmatic management of drug resistant tuberculosis di

Rumah Sakit Umum Pusat H. Adam Malik Medan. J Respir Indo. 2013;33:221-8.

Munir SM, Nawas A, Soetoyo DK. Pengamatan pasien tuberkulosis paru dengan multidrug resistant (TB MDR) di poliklinik paru RSUP

Persahabatan. J Respir Indo. 2008;30:92-104.

Elmi OS, Hasan H, Abdullah S, Mat Jeab MZ, Bin Alwi Z, Naing NN. Multidrug-resistant tuberculosis and risk factors associated with its development: a retrospective study. J Infect Dev Ctries. 2015;9:1076-85.

Nurjana MA. Faktor risiko terjadinya tuberculosis paru usia produktif (15-49 tahun) di Indonesia. Media Penelitian dan Pengembangan Kesehatan. 2015;25:163-70.

Chung-Delgado K, Guillen-Bravo S, Revilla- Montag A, Bernabe-Ortiz A. Mortality among MDR-TB Cases: Comparison with Drug-Susceptible

Tuberculosis and Associated Factors. PLoS One. 2015;10:e0119332.

Akaputra R, Burhan E, Nawas A. Karakteristik dan evaluasi perjalanan penyakit multidrug resistant tuberculosis dengan diabetes melitus dan non diabetes melitus. J Respir Indo. 2008;33:92-102.

Bashar M, Alcabes P, Rom WN, Condos R. Increased incidence of multidrug-resistant tuberculosis in diabetic patients on the Bellevue Chest Service, 1987 to 1997. Chest. 2001;120:1514-9.

Fisher-Hoch SP, Whitney E, McCormick JB, Crespo G, Smith B, Rahbar MH, et al. Type 2 diabetes and multi-drug resistant tuberculosis. Scand J Infect Dis. 2008;40:888-93.

Lee SW, Kang YA, Yoon YS, Um SW, Lee SM, Yoo CG, et al. The prevalence and evolution of anemia associated with tuberculosis. J Korean Med Sci. 2006;21:1028-32.

Faustini A, Hall AJ, Perucci CA. Risk factors for multidrug resistant tuberculosis in Europe: a systematic review. Thorax. 2006;61:158-63.

Kementerian Kesehatan Republik Indonesia Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan. Petunjuk teknis manajemen terpadu pengendalian tuberkulosis resistan obat. Jakarta: Kemenkes RI; 2015.

World Health Organization. Ethical issues in tuberculosis prevention, care, and control [Online]. 2014 [Cited 2016 November 5]. Available from:

Van der Walt M, Lancaster J, Odendaal R, Davis JG, Shean K, Farley J. Serious treatment related adverse drug reactions amongst anti-retroviral naive MDR-TB patients. PLoS One. 2013;8:e58817.

Tag El Din MA, El Maraghy AA, Abdel Hay AHR. Adverse reactions among patients being treated for multi-drug resistant tuberculosis at Abbassia Chest Hospital. Egypt J Chest Dis Tuberc. 2015;64:939-52.

Kusnanto P, Eko V, Pakiding H, Nurwidiasih D. Multidrug resistant tuberculosis (MDR-TB): tinjauan epidemiologi dan faktor risiko efek samping obat anti tuberkulosis. Majalah Kedokteran Bandung. 2014;46:189-96.

Chhabra N, Aseri ML, Dixit R, Gaur S. Pharmacotherapy for multidrug resistant tuberculosis. J Pharmacol Pharmacother. 2012;3:98-104.

Reviono W, Harsini AJ, Sutanto Y. Streptomisin dan insidens penurunan pendengaran pada pasien Multidrug Resistant Tuberculosis di Rumah Sakit Dr Moewardi. J Respir Indo. 2013;33:167-72.

Bhardwaj P, Deshkar AM, Verma R. Side effects encountered in treatment of multidrug-resistant tuberculosis: A 3-year experience at first dots plus site of Chhattisgarh. Int J Sci Stud. 2015;3:104-7.

Pham AQ, Doan A, Andersen M. Pyrazinamide induced hyperuricemia. Pharmacy and Therapeutics. 2014;39:695-715.

Arbex MA, Varella Mde C, Siqueira HR, Mello FA. Antituberculosis drugs: drug interactions, adverse effects, and use in special situations. Part 1: firstline drugs. J Bras Pneumol. 2010;36:626-40.

World Health Organization. Global tuberculosis report. [Online]. 2016 [Cited 2016 November 1]. Available from:

Tola HH, Tol A, Shojaeizadeh D, Garmaroudi G. Tuberculosis Treatment Non-Adherence and Lost to Follow Up among TB Patients with or without HIV in Developing Countries: A Systematic Review. Iranian J Public Health. 2015;44:1-11.



  • There are currently no refbacks.

Jurnal Respirologi Indonesia
pISSN: 0853-7704 - eISSN: 2620-3162
Address: Jalan Cipinang Bunder No. 19, Cipinang, Pulogadung, Jakarta Timur, DKI Jakarta 13240, Indonesia
Phone: +62-21-2247-4845

An official publication by
the Indonesian Society of Respirology (ISR)

Creative Commons License
Creative Commons Attribution-NonCommercial 4.0 International License