Efficacy and Safety of Kanamycin, Ethionamide, Pas and Cycloserrine in Multi Drug Resistant Pulmonary Tuberculosis Patients

Prasad, Rajendra; Verma, Sanjeev Kumar; Jain, Amita

doi:10.1378/chest.128.4_meetingabstracts.176s-c

Cited by 28 publications

(35 citation statements)

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“…These findings are comparable with those of Prasad et al where 21% of the patients developed major adverse events that required stoppage or change of the offending medicines [16]. Similarly, Bloss et al have reported dosage reduction in 20% of the patients treated for MDR-TB [12].…”

Section: Discussionsupporting

confidence: 84%

Occurrence and clinical management of moderate-to-severe adverse events during drug-resistant tuberculosis treatment: a retrospective cohort study

Sagwa

Mantel‐Teeuwisse

Ruswa

2014

J of Pharm Policy and Pract

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ObjectivesTo determine the incidence of symptomatic moderate-to-severe adverse events during treatment of drug-resistant tuberculosis, and to compare their risk and outcomes by patients’ human immunodeficiency virus (HIV) co-infection status.MethodsWe conducted a retrospective cohort analysis of patients treated for drug-resistant tuberculosis between January 2008 and February 2010. Routinely, clinicians monitored and managed patients’ response to treatment until its completion. Any symptomatic adverse event observed by the clinician or reported by the patient was recorded in the standard patient treatment booklet of the National Tuberculosis and Leprosy Programme. There were 18 symptomatic adverse events routinely monitored. Depending on the nature of the medical intervention needed, each was graded as mild, moderate or severe. Data were extracted from the patient treatment booklet using a structured form, then descriptive, bivariate and Cox proportional hazard analysis performed, stratified by patients’ HIV infection status. Statistical associations were done at the 5% level of significance and reported with 95% confidence intervals.ResultsFifty seven (57) patients with drug-resistant tuberculosis were identified, 31 (53%) of whom were HIV co-infected. The cumulative incidence of moderate-to-severe adverse events was 46 events in 100 patients. HIV co-infected patients experienced more moderate-to-severe adverse events compared with the HIV uninfected patients (median 3 versus 1 events, p = 0.01). They had a four-fold increase in the cumulative hazard of moderate-to-severe adverse events compared with the HIV uninfected patients (HR = 4.0, 95% CI 1.5 – 10.5). Moderate-to-severe adverse events were the main determinant of a clinician’s decision to reduce the dose or to stop the suspected offending medicine (RR = 3.8, 95% 1.2-11.8).ConclusionsModerate-to-severe adverse events are common during drug-resistant tuberculosis therapy. They are more likely to occur and to persist in HIV co-infected patients than in HIV uninfected patients. Clinicians should employ various strategies for preventing drug-induced patient discomfort and harm, such as reducing the dose or stopping the suspected offending medicine. Managers of tuberculosis control programmes should strengthen pharmacovigilance systems. We recommend a more powered study for conclusive risk-factor analysis.Electronic supplementary materialThe online version of this article (doi:10.1186/2052-3211-7-14) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 84%

Occurrence and clinical management of moderate-to-severe adverse events during drug-resistant tuberculosis treatment: a retrospective cohort study

Sagwa

Mantel‐Teeuwisse

Ruswa

2014

J of Pharm Policy and Pract

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“…Our patient cohort achieved a conversion rate of 81.4% which is comparable to different studies reported across globally. [10][11][12] Around 70% of patients in our study had a sputum culture conversion at 3 months. However, 22 patients (22%) out of them still had an unsuccessful end treatment outcome.…”

Section: Discussionmentioning

confidence: 99%

Analysis of treatment outcome in multi-drug resistant tuberculosis patients treated under programmatic conditions

2017

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Background: Programmatic management of MDR-TB has taken over the un-standardized and unsupervised treatment practice in India. However, despite being implemented in whole of country, the data on the program surveillance is scarce. Hence the present study was sought to evaluate the treatment outcome in patients with MDR TB in Chandigarh being treated under programmatic conditions.Methods: A retrospective study was carried out by enrolling all MDR-TB patients registered between January 2012 to December 2014. Medical records of 140 patients were scrutinized for necessary information on demographic, clinical parameters and previous TB treatment. Treatment outcomes to Cat IV anti-TB therapy, any interruptions in treatment, adverse drug reactions, culture conversion etc. were evaluated from the records.Results: Of the 140 patients, 77 (55%) were declared cured, 11 (7.9%) completed treatment, 23 patients (16.4%) died, 13 (9.3%) defaulted on treatment, 5 (3.6%) had treatment failure and 11 (7.9%) were shifted to Cat V therapy. On comparison, BMI, haemoglobin, treatment outcome in previous ATT, treatment adherence and time to sputum culture conversion were significantly different in different treatment outcome groups.Conclusions: The treatment success rate of MDR‑TB patients have shown improvement under programmatic conditions. Interventions to improve BMI and treatment adherence might further help to improve the success rate.

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“…Some authors reported that 41% patients experienced some side effects and only 21.1% patients required stoppage or change of drug in their study of 39 patients of MDR-TB. 2 Close monitoring of the patients is necessary to ensure that the adverse effects of second line drugs are recognized quickly. The ability to monitor patients for adverse effects daily is one of the major advantages of Directly Observed Treatment as in category IV treatment running as a pilot project in some states of India.…”

Section: Introductionmentioning

confidence: 99%

Side Effects Associated With Drugs Used in Treatment of Multi Drug Resistant Tuberculosis and Treatment Related Factors of Multi Drug Resistant Tuberculosis Patients in Kathmandu Valley

Bhatt

2017

SAARC J. Tuber. Lung Dis. HIV/AIDS

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Introduction: Treatment of multi drug resistant Mycobacterium tuberculosis (MDR-TB) with second line drugs is associated with adverse drug reactions and toxicity. Aim of this study were to determine side effects associated with drugs used in treatment of multi drug resistant tuberculosis and treatment related factors of MDR-TB patients.Methodology: A prospective study was carried out in National Tuberculosis Centre Bhaktapur Nepal. Questionnaires were used to collect data from patients.Results: Total 101 MDR TB patients were included among them majorities were male (52%) and mean age of the patients was 31.2 years. Majority of patients (87.1%) had previous history of tuberculosis treatment and 54.5% were in intensive phase of treatment. The side effect associated with drugs used in treatment of MDR-TB reported by patients were joint pain (21.2%), nausea (20.3%), hearing disturbances (11%), gastrointestinal disturbance (9.9%), depression (9.6%), itching (8.1%), hypothyroidism (6.4%), dizziness (6.4%), seizures (3.8%) and hepatitis (3.5%). Last month 25.74% patients missed one or more doses of drugs and 3.9% missed drug doses due to side effect of drugs. Majorities of the patients used vehicle to reach health centre (92.07%), time to reach the health center (59.4%) were less than 30 minutes but majorities of patients (57.4%) were not satisfied by the counseling of health care worker.Conclusion: The finding of this study shows that in MDR patients 12.8% were found new cases. Last month 3.9% patients were stopped the drugs due to side effects of drugs. Majority of patients (57.4%) were not satisfied by counseling of health care worker. Treatment of multi drug resistant tuberculosis with second line anti tubercular drugs is associated with side effects, health care worker counseling to MDR- TB patients with full attention is essential to encourage the patient’s moral and complete the treatment. Timely managing the side effects of medication is important in helping people to complete their treatment.SAARC J TUBER LUNG DIS HIV/AIDS, 2017; XIV(1), Page: 1-6

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Efficacy and Safety of Kanamycin, Ethionamide, Pas and Cycloserrine in Multi Drug Resistant Pulmonary Tuberculosis Patients

Cited by 28 publications

References 0 publications

Occurrence and clinical management of moderate-to-severe adverse events during drug-resistant tuberculosis treatment: a retrospective cohort study

Occurrence and clinical management of moderate-to-severe adverse events during drug-resistant tuberculosis treatment: a retrospective cohort study

Analysis of treatment outcome in multi-drug resistant tuberculosis patients treated under programmatic conditions

Side Effects Associated With Drugs Used in Treatment of Multi Drug Resistant Tuberculosis and Treatment Related Factors of Multi Drug Resistant Tuberculosis Patients in Kathmandu Valley

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