Rajendra Prasad1, Abhijeet Singh2, Rahul Srivastava2, Giridhar B Hosmane2, Ram Awadh Singh Kushwaha2, Amita Jain3. 1. Department of Pulmonary Medicine, King George Medical University, Lucknow, India. Electronic address: rprasadkgmc@gmail.com. 2. Department of Pulmonary Medicine, King George Medical University, Lucknow, India. 3. Department of Microbiology, King George Medical University, Lucknow, India.
Abstract
BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is considered to be a worldwide problem with notoriously difficult and challenging treatment. Adverse events associated with second-line drugs (SLDs) can have severe impact on efficient management. OBJECTIVE: To know the frequency of adverse events due to SLDs in patients of MDR-TB. DESIGN: A prospective cohort analysis of 98 MDR-TB patients enrolled between June 2009 to February 2010 was conducted in Department of Pulmonary Medicine, King George Medical University, Lucknow, India. All the patients were provided standardized regimen. Adverse events associated with treatment were recognized primarily by clinical evidence and/or laboratory investigations that were advised at baseline and whenever clinically indicated during course of treatment. Adverse events were considered major if required permanent discontinuation or substitution of drugs. RESULTS: 119 adverse events were reported in 46 (46.9%) patients. The grouped adverse events were most commonly gastrointestinal that was observed with a frequency of 48 (40.3%) followed by ototoxicity in 28 (23.6%), and neurological in 21 (17.6%). 17 (17.4%) patients had major adverse events requiring permanent discontinuation or substitution of drugs that included deafness and tinnitus in 5 (5.1%) followed by psychosis in 4 (4.1%). None of the patients stopped complete regimen due to adverse events. The treatment success rate was observed to be 71 (72.4%). CONCLUSIONS: MDR-TB can be cured successfully with appropriate combination of drugs if adverse events associated with them can be managed aggressively and timely. Newer and less toxic drugs are urgently needed to treat MDR-TB patients.
BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is considered to be a worldwide problem with notoriously difficult and challenging treatment. Adverse events associated with second-line drugs (SLDs) can have severe impact on efficient management. OBJECTIVE: To know the frequency of adverse events due to SLDs in patients of MDR-TB. DESIGN: A prospective cohort analysis of 98 MDR-TB patients enrolled between June 2009 to February 2010 was conducted in Department of Pulmonary Medicine, King George Medical University, Lucknow, India. All the patients were provided standardized regimen. Adverse events associated with treatment were recognized primarily by clinical evidence and/or laboratory investigations that were advised at baseline and whenever clinically indicated during course of treatment. Adverse events were considered major if required permanent discontinuation or substitution of drugs. RESULTS: 119 adverse events were reported in 46 (46.9%) patients. The grouped adverse events were most commonly gastrointestinal that was observed with a frequency of 48 (40.3%) followed by ototoxicity in 28 (23.6%), and neurological in 21 (17.6%). 17 (17.4%) patients had major adverse events requiring permanent discontinuation or substitution of drugs that included deafness and tinnitus in 5 (5.1%) followed by psychosis in 4 (4.1%). None of the patients stopped complete regimen due to adverse events. The treatment success rate was observed to be 71 (72.4%). CONCLUSIONS: MDR-TB can be cured successfully with appropriate combination of drugs if adverse events associated with them can be managed aggressively and timely. Newer and less toxic drugs are urgently needed to treat MDR-TB patients.
Authors: Maria Antonietta Barbieri; Giuseppe Cicala; Paola Maria Cutroneo; Eleonora Mocciaro; Laura Sottosanti; Francesco Freni; Francesco Galletti; Vincenzo Arcoraci; Edoardo Spina Journal: Front Pharmacol Date: 2019-10-08 Impact factor: 5.810
Authors: Muhammad Atif; Waqar Ahmed; Muhammad Nouman Iqbal; Nafees Ahmad; Wajiha Ahmad; Iram Malik; Yaser Mohammed Al-Worafi Journal: Front Med (Lausanne) Date: 2022-03-01