Introduction. Treatment for multidrug-resistant tuberculosis lasts 18 to 24 months, so there is a high rate of therapy interruptions, including patient-initiated interruptions. In recent years, the use of shorter regimens for the treatment of multidrug-resistant tuberculosis has been actively discussed around the world. The first use of shorter chemotherapy regimens was conducted in three regions of the Russian Federation in 2019. However, the prevalence of the use of shorter chemotherapy regimens in our country remains low.The purpose of the study was to demonstrate the high efficacy of a shortened chemotherapy regimen with surgical intervention.Materials and methods. In the conditions of the Central Research Institute of Tuberculosis, the patient underwent a comprehensive examination, including mandatory, additional and optional methods of investigation. Based on the findings of the comprehensive examination and established broad drug resistance of Mycobacterium tuberculosis, a shorter course of chemotherapy was prescribed and surgical treatment was performed after 2 months of therapy.Results and Discussion It was decided to carry out anti-tuberculosis therapy according to a shortened scheme in the amounts: Linezolid, Bedaquiline, Cycloserine, Levofloxacin, Pyrazinamide. Taking into account positive radiological dynamics after two months of treatment and absence of contraindications, early surgery intervention was performed. At the end of a nine-month course of chemotherapy the patient had a stable radiological picture, “fresh” focal and infiltrative changes in the lungs were not detected. Early surgical treatment with a shorter chemotherapy regimen may become a highly effective method in the cure of drug-resistant tuberculosis in the Russian Federation.Conclusion. A shorter chemotherapy regimen with optimal timing of surgical intervention is highly effective and safe to use.

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According to the WHO, tobacco use is currently the leading cause (16%) of all adult deaths. Studies conducted in many countries and in the Russian Federation have revealed the association between smoking and pulmonary tuberculosis (PT). Due to the negative impact of tobacco smoking on the course of tuberculosis and the effectiveness of treatment, there is a need to develop approaches to smoking cessation in patients with PT. Aim. To evaluate the effectiveness of the treatment of PT in smoking patients in combination with nicotine replacement therapy in an inpatient setting. Methods. The study included 27 patients with a confirmed diagnosis of PT. The inclusion criteria for the study were: age 18 years and older, patients who are currently active smokers, and a confirmed diagnosis of PT. The exclusion criteria were the presence of asthma and oncological diseases, unconfirmed diagnosis of PT, and earlier history of tobacco use. In the study group, an analysis of the smoking status was carried out. This status was based on the length of smoking period, number of cigarettes per day, and calculation of the smoking patient index. The degree of nicotine addiction, the presence of withdrawal symptoms, and the motivation of patients to quit smoking were assessed. The principle of nicotine dependence treatment was to prescribe nicotine-containing drugs in a dose depending on the degree of nicotine addiction. The duration of treatment was 12 weeks. Results. After 4 months of PT treatment, the cessation of bacterial excretion was detected 2 times more often, the closure of decay cavities in the lung tissue - 2.5 times more often, the relief of systemic inflammatory reactions - 2 times more often in patients who quit smoking than in patients who continue to smoke. Conclusion. This study showed that the treatment of PT in smokers was more effective in combination with nicotine replacement therapy for smoking cessation than when the patients continued to smoke.