Objetivo: Avaliar as principais alterações clínicas responsáveis pela troca do esquema padrão anti-hansênico e traçar o perfil epidemiológico destes pacientes, em caráter regional. Métodos: Estudo transversal, retrospectivo utilizando prontuários dos pacientes com hanseníase de Janeiro de 2006 a Dezembro de 2016, na unidade de saúde Policlínica Luiz Santos Filho, Gurupi-Tocantins, com enfoque para os casos em uso de esquema alternativo. Resultados: Registrou-se 1.240 casos de hanseníase no município, destes, 86 (6,93%) foram intolerantes à poliquimioterapia inicial. A Dapsona foi a droga mais substituída, 88,37% dos casos. A síndrome anêmica foi a principal alteração encontrada (56,97%). Não houve correlação significativa entre o número de notificações e substituições (ρ = - 0,229) (α=0,05). Conclusões: Apesar da baixa taxa de substituições, é fundamental a capacitação das equipes de saúde no reconhecimento da intolerância medicamentosa no tratamento da hanseníase, fortalecendo adesão terapêutica e o combate a hanseníase enquanto problema de saúde pública. Palavras-chave: Hanseníase; Toxicidade de drogas; Quimioterapia combinada; Sintomas clínicos. ABSTRACT Objective: To evaluate the main clinical changes responsible for the substitution of the standard anti-leprosy treatment and identify the epidemiological profile of patients with leprosy on a regional basis. Methods: A cross-sectional retrospective study was conducted using records of patients with leprosy from January 2006 to December 2016 at the Luiz Santos Filho Polyclinic health unit, Gurupi-Tocantins, focusing on cases using an alternative treatment. Results: A total of 1,240 patients with leprosy were registered in the city, of which 86 (6.93%) were intolerant to initial polychemotherapy. Dapsone was the most commonly substituted drug in 88.37% of the cases. Anemic syndrome was the main change identified (56.97%). There was no significant correlation between the number of notifications and substitutions (ρ=-0.229) (α=.05). Conclusion: Despite the low substitution rates found, it is essential to train healthcare teams to recognize drug intolerance in the treatment of leprosy, improving therapeutic adherence and treating leprosy as a public health problem. Keywords: Leprosy; Drug toxicity; Drug combinations; Clinical symptoms.
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