Side-effects of multidrug-resistant tuberculosis treatment

Abstract

Background. Drug resistance threatens global tuberculosis control efforts. Objective of the study. In this study was to assess adverse reactions of second-line TB drugs in patients treated for MDR-TB at Institute of Phthisiopneumology “K. Draganiuc” in 2017. Material and Methods. The 107 patients were resistant to all first line drugs. Results. 72.9% of the patients were males and 27.1% were females. The mean of age was 37.1 years. The most common co-morbidities associated with MDR-TB in the studied cases were diabetes (29.9%). Side effects of drugs were; 57% GIT manifestations, 53.3% peripheral neuritis, hypokalemia 26.2%, irritable bowel syndrome 22.4%, ototoxicity 17.8%, skin reaction 10.3%, hypothyroidism 10.3%, hepatotoxicity 9.3%, hypoalbuminemia 5.6%, depression 3.7%, arthritis 0.9%, gynecomastia 2.8%, hyponatremia 5.6%, hypomagnesaemia 1.9%, dizziness 0.9%, nephrotoxicity 3.7%. Most of the drugs’ side effects started to appear within the first 3 months of treatment. Conclusion. The most common type of resistance is acquired resistance because of lack of adherence to treatment or inappropriate treatment. The most common side effects of MDR TB treatment were gastrointestinal manifestations. Most side effects occurred within the first 3 months of treatment.

Introducere. Rezistența la medicamente antiruberculoase amenință eforturile globale de control al tuberculozei. Scopul lucrării. Evaluarea reacțiilor adverse ale medicamentelor de linia a doua la pacienții tratați cu TB MDR la Institutul de Fiziopneumologie „C. Draganiuc” în 2017. Material și Metode. 107 pacienți au fost rezistenți la toate medicamentele de primă linie. Rezultate: 72,9% dintre pacienți au fost bărbați și 27,1% femei. Vârsta medie a fost de 37,1 ani. Cele mai frecvente comorbidități asociate cu TB MDR în cazurile studiate au fost diabetul (29,9%). Efectele adverse au fost: 57% manifestări gastro-intestinale, 53,3% neurită periferică, hipokalemie 26,2%, sindromul itestinului iritat 22,4%, ototoxicitate 17,8%, reacții cutanate 10,3%, hipotiroidism 10,3%, hepatotoxicitate 9,3%, hipoalbuminemie 5,6%, depresie 3,7%, artrită 0,9%, ginecomastie 2,8%, hiponatremie 5,6%, hipomagneziemie 1,9%, amețeli 0,9%, nefrotoxicitate 3,7%. Majoritatea efectelor adverse au apărut în primele 3 luni de tratament. Concluzii. Majoritatea au avut rezistență dobândită din cauza lipsei de aderență la tratament sau a tratamentului necorespunzător. Cele mai frecvente efecte adverse au fost manifestările gastroitestinale. Cele mai multe efecte adverse au apărut în primele 3 luni de tratament.