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 JTR  Vol.3 No.2 , June 2015
Adverse Drug Reactions in Management of Multi Drug Resistant Tuberculosis, in Tertiary Chest Institute
Abstract: Background: Multidrug resistant tuberculosis is a global threat. Effective treatment is implemented as per RNTCP guidelines. But the drugs used have great potential to develop adverse drug reactions. Such drug reactions if not managed optimally can lead to unfavourable treatment outcome. Hence, the study is to know the occurrence of adverse drug reactions. Aims: To study the occurrence of adverse drug reactions in treatment of multidrug resistant tuberculosis and hence the factors affecting the treatment. Settings and Design: Retrospective analysis of patients treated with standardised regimen for MDR-TB, as per RNTCP guidelines at a tertiary chest institute between august 2011 and December 2014. Methods and Material: Retrospective analysis of 607 patients’ records reviewed for the occurrence of adverse drug reactions. All adverse reactions are noted and diagnosed either clinically or by laboratory evidence. Results: Among the 607 patients included in the study, majority had one or more adverse drug reactions. The most common was gastritis (71.7%), which was easily treatable, and the least common was visual impairment (0.2%). Only 1.7% discontinued the treatment citing adverse drug reactions and 10.5% required permanent discontinuation of the offending drug. Conclusion: Treatment of MDR-TB is challenging mainly due to the long duration of treatment and the potential adverse reactions of the drugs used. These reactions are frequent but majority of them can be successfully managed without treatment interruption. Training the peripheral health centre workers to identify and refer the patients with adverse reaction bears a major impact on treatment outcome.
Keywords: MDR-TB, ADR, Adherence, Outcome
Cite this paper: Akshata, J. , Chakrabarthy, A. , Swapna, R. , Buggi, S. and Somashekar, M. (2015) Adverse Drug Reactions in Management of Multi Drug Resistant Tuberculosis, in Tertiary Chest Institute. Journal of Tuberculosis Research, 3, 27-33. doi: 10.4236/jtr.2015.32004.
References

[1]   WHO (2014) Global Tuberculosis Report 2014—Drug Resistant TB: Surveillance and Response.

[2]   Central TB Division (CTD), Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India (2006) DOTS-Plus Guidelines. CTD, New Delhi.

[3]   KapadiaVishakha, K. and Tripathi Sanjay, B. (2013) Analysis of 63 Patients of MDR TB on DOTS Plus regimen: An LG Hospital, TB Unit, Ahmedabad Experience. Gujarat Medical Journal, 68, 52-57.

[4]   Joseph, P., Rao Desai, V.B., Mohan, N.S., Fredrick, J.S., Ramachandran, R., Raman, B., et al. (2011) Outcome of Standardized Treatment for Patients with MDR-TB from Tamil Nadu, India. Indian Journal of Medical Research, 133, 529-534.

[5]   Shin, S.S., Pasechnikov, A.D., Gelmanova, I.Y., Peremitin, G.G., Strelis, A.K., Mishustin, S., et al. (2007) Adverse Reactions among Patients Being Treated for MDR-TB in Tomsk, Russia. The International Journal of Tuberculosis and Lung Disease, 11, 1314-1320.

[6]   Furin, J.J., Mitnick, C.D., Shin, S.S., Bayona, J., Becerra, M.C., Singler, J.M., et al. (2001) Occurrence of Serious Adverse Effects in Patients Receiving Community-Based Therapy for Multidrug-Resistant Tuberculosis. The International Journal of Tuberculosis and Lung Disease, 5, 648-655

[7]   Nathanson, E., Gupta, R., Huamani, P., Leimane, V., Pasechnikov, A.D., Tupasi, T.E., et al. (2004) Adverse Events in the Treatment of Multidrug-Resistant Tuberculosis: Results from the DOTS-Plus Initiative. The International Journal of Tuberculosis and Lung Disease, 8, 1382-1384.

[8]   Elmahallawy, I.I., Bakr, R.M., Mabrouka, A.A. and Omar, R.M. (2012) Treatment Outcomes among Patients with Multi-Drug Resistant Tuberculosis in Abbassia Chest Hospital from July 2006 to June 2010. Egyptian Journal of Chest Diseases and Tuberculosis, 61, 337-342.
http://dx.doi.org/10.1016/j.ejcdt.2012.08.018

 
 
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