SETTING: A community-based treatment program for multidrug-resistant tuberculosis (MDR-TB) in an urban shantytown of Lima, Peru. OBJECTIVES: To ascertain the occurrence of serious adverse effects associated with therapy for MDR-TB in northern Lima, Peru, where therapy was individualized according to drug-susceptibility testing of patients' infecting strains and delivered through a community-based program. DESIGN: A retrospective record review of 60 patients who had received individualized therapy for MDR-TB between September 1996 and October 1998. RESULTS: Although adverse effects were common, they occurred less frequently than previously reported in the literature and were rarely life-threatening. Effects occurring most frequently in this population included: mild gastritis (100%), dermatological effects (43.3%), peripheral neuropathy (16.7%), depression (18.3%), and anxiety (11.7%). These effects never resulted in the discontinuation of anti-tuberculosis therapy, and only occasionally resulted in the suspension of an agent (11.7%). CONCLUSION: In young patients with little comorbid disease, multidrug, long-course regimens rarely caused life-threatening adverse effects. Common side effects may be managed successfully on an out-patient basis through a community-based treatment program in conjunction with MDR-TB experts, even in resource-poor settings. The very low rate of default in this cohort offers hope that strategies to manage the adverse effects may reduce the incidence of abandonment of therapy and increase rates of cure.
SETTING: A community-based treatment program for multidrug-resistant tuberculosis (MDR-TB) in an urban shantytown of Lima, Peru. OBJECTIVES: To ascertain the occurrence of serious adverse effects associated with therapy for MDR-TB in northern Lima, Peru, where therapy was individualized according to drug-susceptibility testing of patients' infecting strains and delivered through a community-based program. DESIGN: A retrospective record review of 60 patients who had received individualized therapy for MDR-TB between September 1996 and October 1998. RESULTS: Although adverse effects were common, they occurred less frequently than previously reported in the literature and were rarely life-threatening. Effects occurring most frequently in this population included: mild gastritis (100%), dermatological effects (43.3%), peripheral neuropathy (16.7%), depression (18.3%), and anxiety (11.7%). These effects never resulted in the discontinuation of anti-tuberculosis therapy, and only occasionally resulted in the suspension of an agent (11.7%). CONCLUSION: In young patients with little comorbid disease, multidrug, long-course regimens rarely caused life-threatening adverse effects. Common side effects may be managed successfully on an out-patient basis through a community-based treatment program in conjunction with MDR-TB experts, even in resource-poor settings. The very low rate of default in this cohort offers hope that strategies to manage the adverse effects may reduce the incidence of abandonment of therapy and increase rates of cure.
Authors: M Buziashvili; V Mirtskhulava; M Kipiani; H M Blumberg; D Baliashvili; M J Magee; J J Furin; N Tukvadze; R R Kempker Journal: Int J Tuberc Lung Dis Date: 2019-09-01 Impact factor: 2.373
Authors: A C Sweetland; A Kritski; M A Oquendo; M E Sublette; A Norcini Pala; L R Batista Silva; A Karpati; E C Silva; M O Moraes; J R Lapa E Silva; M L Wainberg Journal: Int J Tuberc Lung Dis Date: 2017-08-01 Impact factor: 2.373
Authors: María Luisa Aznar; Ariadna Rando Segura; María Milagros Moreno; Mateu Espasa; Elena Sulleiro; Cristina Bocanegra; Eva Gil Olivas; Arlete Nindia Eugénio; Adriano Zacarias; Domingos Katimba; Estevao Gabriel; Jacobo Mendioroz; Maria Teresa López García; Tomas Pumarola; María Teresa Tórtola; Israel Molina Journal: Am J Trop Med Hyg Date: 2019-09 Impact factor: 2.345
Authors: James C M Brust; N Sarita Shah; Theo L van der Merwe; Sheila Bamber; Yuming Ning; Moonseong Heo; Anthony P Moll; Marian Loveday; Umesh G Lalloo; Gerald H Friedland; Neel R Gandhi Journal: J Acquir Immune Defic Syndr Date: 2013-04-01 Impact factor: 3.731
Authors: Carole D Mitnick; Sonya S Shin; Kwonjune J Seung; Michael L Rich; Sidney S Atwood; Jennifer J Furin; Garrett M Fitzmaurice; Felix A Alcantara Viru; Sasha C Appleton; Jaime N Bayona; Cesar A Bonilla; Katiuska Chalco; Sharon Choi; Molly F Franke; Hamish S F Fraser; Dalia Guerra; Rocio M Hurtado; Darius Jazayeri; Keith Joseph; Karim Llaro; Lorena Mestanza; Joia S Mukherjee; Maribel Muñoz; Eda Palacios; Epifanio Sanchez; Alexander Sloutsky; Mercedes C Becerra Journal: N Engl J Med Date: 2008-08-07 Impact factor: 91.245
Authors: Kwonjune J Seung; David B Omatayo; Salmaan Keshavjee; Jennifer J Furin; Paul E Farmer; Hind Satti Journal: PLoS One Date: 2009-09-25 Impact factor: 3.240