Adverse reactions to antituberculosis drugs in Manguinhos, Rio de Janeiro, Brazil

Abstract

OBJECTIVES:This study aimed to characterize and estimate the frequency of adverse reactions to antituberculosis drugs in the population treated at the Centro de Saúde Escola Germano Sinval Faria, a primary health care clinic in Manguinhos, Rio de Janeiro City, and to explore the relationship between adverse drug reactions and some of the patients' demographic and health characteristics.METHODS:This descriptive study was conducted via patient record review of incident cases between 2004 and 2008.RESULTS:Of the 176 patients studied, 41.5% developed one or more adverse reactions to antituberculosis drugs, totaling 126 occurrences. The rate of adverse reactions to antituberculosis drugs was higher among women, patients aged 50 years or older, those with four or more comorbidities, and those who used five or more drugs. Of the total reactions, 71.4% were mild. The organ systems most affected were as follows: the gastrointestinal tract (29.4%), the skin and appendages (21.4%), and the central and peripheral nervous systems (14.3%). Of the patients who experienced adverse reactions to antituberculosis drugs, 65.8% received no drug treatment for their adverse reactions, and 4.1% had one of the antituberculosis drugs suspended because of adverse reactions. “Probable reactions” (75%) predominated over “possible reactions” (24%). In the study sample, 64.3% of the reactions occurred during the first two months of treatment, and most (92.6%) of the reactions were ascribed to the combination of rifampicin + isoniazid + pyrazinamide (Regimen I). A high dropout rate from tuberculosis treatment (24.4%) was also observed.CONCLUSION:This study suggests a high rate of adverse reactions to antituberculosis drugs.

Adverse drug reactions associated with first line anti-tubercular drugs, their prevalence and causality assessment in patients on Directly Observed Treatment Short-course (DOTS) in a tertiary care hospital

“…Ramanath et al, reported similar findings with most (92.97%) ADRs showing a possible causal relationship. 21 Similar results have been reported by Damasceno et al 22 Present study had three certain/definite (5.30%) cases in which re-challenge was done and offending drug was found to be pyrazinamide. A study conducted by Verma et al, categorised 9.8% of the cases as definite/severe.…”

The combined fixed-dose antituberculous drugs alter some reproductive functions with oxidative stress involvement in wistar rats

“…Previous reports of some notable adverse drug reactions include weight increase and hepatotoxicity [29] , [45] , reproductive toxicity [29] , exanthema, hematological [46] among others when RIPE is used either as the sole agent or together. In fact, antituberculosis drug-induced hepatotoxicity has been reviewed [47] .…”

Clinical and epidemiological features of tuberculosis in children and adolescents

“…Another point that can lead to abandonment, and consequently drug-resistance, is the adverse effects that medication brings. In Rio de Janeiro it was possible to find side effects in 22.2% of the people from 0-19 years old (39) .…”