Hepatotoxicity of antituberculosis drugs.

Ormerod, L P; Skinner, Craig; Wales, J. K.

doi:10.1136/thx.51.2.111

Cited by 59 publications

(49 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The most common side effect of antituberculosis therapy is hepatotoxicity, followed by skin reactions [8,9]. The three most important drugs (INH, RMP, PZA) are hepatotoxic.…”

Section: Discussionmentioning

confidence: 99%

“…The second major problem in the treatment of TB is patients with severe intolerance reactions to ®rst line antituberculosis drugs [8,9]. The most common side effect of antituberculosis therapy is hepatotoxicity, followed by skin reactions [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors for hepatotoxicity are age ¢60 yrs, history of hepatitis, concomitant intake of other hepatotoxic drugs, diabetes mellitus and alcohol and i.v. drug abuse [8,9]. As patients with intolerance also require effective combination therapy with at least three active drugs [29], spar¯oxacin may be administered alternatively in these cases.…”

Section: Discussionmentioning

confidence: 99%

“…The global increase of multiresistant Mycobacterium tuberculosis strains [2±7] and intolerance of ®rst line antituberculosis drugs (INH, RMP, PZA, EMB, streptomycin (SM)) [8,9] may cause major treatment problems and necessitate modi®cation of the standard therapy regimen.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Sparfloxacin in the treatment of drug resistant tuberculosis or intolerance of first line therapy

Lubasch¹,

Erbes²,

Mauch³

et al. 2001

Eur Respir J

View full text Add to dashboard Cite

Patients with multiresistant tuberculosis (TB) and patients with intolerance of first line antituberculosis drugs present a major treatment problem. Sparfloxacin is highly active against mycobacteria, but the use is restricted by side effects and the contribution to antituberculosis therapy is unclear. A prospective study has therefore been performed to analyse the efficacy and tolerability of sparfloxacin in cases of resistant TB or intolerance of first line therapy.Between April 1993 and April 1999, 30 TB patients (28 with pulmonary TB and two with lymph node TB) were treated with combinations of sparfloxacin and at least two other drugs at the Chest Hospital Heckeshorn, Berlin. Sixteen patients were infected by resistant mycobacteria (one single drug resistance (SDR), one polyresistance, and 14 multidrug resistances (MDR); 14 males (age range 23–53 yrs), 2 females (68–74 yrs)). Twelve patients (11 males, one female, 27–80 yrs) had not tolerated first line antituberculosis drugs. Two additional male patients had continuous proof ofMycobacterium tuberculosisin sputum without resistance during therapyThe duration of sparfloxacin therapy during hospitalization ranged 2.5–4 months. Twenty-five patients completed therapy and were cured according to this study's definition. Although sparfloxacin was generally well tolerated, five mild phototoxic reactions and six moderate prolongations of the electrocardiographic QT-interval (30–40 ms compared to baseline ≤450 ms) were registered without clinical symptoms in the patient group.In summary, sparfloxacin proved an effective and safe alternative antituberculosis drug for complicated tuberculosis.

show abstract

“…The most common side effect of antituberculosis therapy is hepatotoxicity, followed by skin reactions [8,9]. The three most important drugs (INH, RMP, PZA) are hepatotoxic.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Sparfloxacin in the treatment of drug resistant tuberculosis or intolerance of first line therapy

Lubasch¹,

Erbes²,

Mauch³

et al. 2001

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…8 Infrequently these changes leads to infl ammation, cell death, or major histopathological changes. 9 On histopathological examination, focal hepatic necrosis maybe revealed with bridging in serious cases. 10 Various studies have been conducted to develop the most effi cient way to eliminate or minimize the hepatotoxicity of anti-TB drugs, by using the natural botanical and/or synthetic drug products without interacting their therapeutic actions.…”

Section: Introductionmentioning

confidence: 99%

Hepatoprotective Effect of Calotropis procera in Isoniazid and Rifampicin Induced Hepatotoxicity

Kamil¹,

Imran-ul-Haque²

2014

Phcog J.

View full text Add to dashboard Cite

Objective: In this study anti-tubercular (Anti-TB) drugs (isoniazid [INH] and rifampicin [RMP]) induced liver toxicity has been studied for the hepatoprotective effect of hydroethanolic extract of Calotropis procera (CP) fl owers in rats. Materials and Methods: Animals were divided into four groups, group A was given normal saline (1 ml/kg), group B received INH (50 mg/kg) and RMP (100 mg/kg) group C received INH (50 mg/kg), RMP (100 mg/kg) and CP (150 mg/kg) orally for 14 days. Results: Biochemical markers of liver toxicity such as aspartate aminotransferase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), and bilirubin and tissue histology were done inall groups. Anti-TB drugs (INH 50 mg/kg and RMP 100 mg/kg) have enhanced the ALT, AST, ALP, bilirubin and histological changes in liver, whereas co-administration of anti-TB drugs with CP has reduced these levels within the normal range. Conclusion: Findings of this study showed the hepatoprotective effect of CP against INH and RMP administration to reduce the liver damage for chronic treatment.

show abstract

Hepatic enzyme abnormalities in children on triple therapy for tuberculosis

Corrigan

Paton

1999

Pediatr. Pulmonol.

View full text Add to dashboard Cite

Standard chemotherapy for tuberculosis (TB) in children uses hepatotoxic drugs. Published data and guidelines on monitoring of liver function during TB treatment are often contradictory and not directly relevant to the pediatric population. We carefully monitored 43 children (age 6.6 years, 0.7–15.1 [median, range]; 49% male; 72% Caucasian) being treated for TB infection (n = 8) or disease (n = 35) with triple therapy, using pyrazinamide, rifampicin, and isoniazid in standard recommended doses. Children on other hepatotoxic drugs were excluded. Measurements of liver function tests (LFT) included aspartate transaminase (AST), alanine transaminase (ALT), and bilirubin, and they were checked before and a median of 5 times (1–23) during treatment. Only one child had mildly abnormal LFTs pretreatment. Thirteen children (n = 13, [30%]; age 7.6 years, 1.8–10.9; 54% male; 77% Caucasian) developed abnormal LFTs (> mean + 2 SD) and of these 10 had TB disease. Eight of the 13 had mildly elevated enzymes (< twice upper limit of normal) while in five, all with disease, the enzymes were more markedly raised. In the group with normal LFTs (n = 30, [70%]; age 6.6 years 0.7–15.1; 47% male; 70% Caucasian) 25 had disease (83%). Liver enzyme elevation occurred early (1.65 weeks, 0.6–16.6). Only two children had symptoms (one jaundice, one pruritus) with treatment being stopped temporarily only in the jaundiced child. Otherwise, LFTs normalized without interrupting treatment. We conclude that elevated liver enzymes are not uncommon in children receiving triple therapy for TB, generally occurring early in treatment. Symptoms are rare. Current British Thoracic Society and American Thoracic Society guidelines (that if LFTs are normal prior to treatment then further monitoring should only be performed if clinically indicated) seem adequate for children. Pediatr Pulmonol. 1999; 27:37–42. © 1999 Wiley‐Liss, Inc.

show abstract

Hepatotoxicity of antituberculosis drugs.

Cited by 59 publications

References 12 publications

Sparfloxacin in the treatment of drug resistant tuberculosis or intolerance of first line therapy

Sparfloxacin in the treatment of drug resistant tuberculosis or intolerance of first line therapy

Hepatoprotective Effect of Calotropis procera in Isoniazid and Rifampicin Induced Hepatotoxicity

Hepatic enzyme abnormalities in children on triple therapy for tuberculosis

Contact Info

Product

Resources

About