Treatment of cycloserine induced psychosis - a case series

2011 ◽  
Vol 26 (S2) ◽  
pp. 1227-1227
Author(s):  
S. Bangar
Keyword(s):  
Case Series ◽  
Multi Drug Resistance ◽  
Psychotic Symptoms ◽  
Drug Resistant ◽  
Anti Psychotic ◽  
Psychotic Illness ◽  
Resistant Tuberculosis ◽  
Life Threatening Illness ◽  
Multi Drug Resistant Tuberculosis ◽  
Life Threatening

IntroductionCycloserine is a highly effective second line anti-tuberculosis medication, the use of which has increased in recent times due to emergence of multi-drug resistance. One of the side-effects is psychosis characterized by paranoia, hallucinations and affective instability. These symptoms are usually reported within the first 2 weeks of therapy in 30–50% of patients receiving Cycloserine 500 mg. At a dose of 100mg and above it leads to a hyperdopaminergic state which in turn could lead to psychosis. However, as this is a very effective treatment in people with multi-drug resistant tuberculosis, it is not always possible to omit treatment due to remergence of life threatening illness. We present findings from few patients on this medication who were referred to us for management of psychotic symptoms.Aims and objectivesTo treat the psychotic symptoms with anti-psychotic which would enable patient to continue Cycloserine. Also to monitor the response to an anti-psychotic.MethodsData was collected from the patient’s case notes, full psychiatric assessment and interviewing the relative. Patient was followed up in the out-patient clinic to monitor response to anti-psychotic medication.ResultsPatients were treated with both typical and atypical medication with good response and it was possible to continue with Cycloserine in one case.ConclusionCycloserine induced psychosis can mimic any other psychotic illness and can be effectively treated with anti-psychotics.

scholarly journals The Quest for Novel Antimicrobials from Bacteria

2012 ◽  
pp. 63-66
Author(s):  
Alan James Marsh
Keyword(s):  
Methicillin Resistant Staphylococcus Aureus ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Antimicrobial Compounds ◽  
Resistant Tuberculosis ◽  
Life Threatening Illness ◽  
Drug Resistant Bacteria ◽  
Multi Drug Resistant Tuberculosis ◽  
Life Threatening ◽  
Tuberculosis Meningitis

Imagine a world without antibiotics. A world where diseases such as syphilis, tuberculosis, meningitis were still commonplace, where a scrape on a leg could develop into life-threatening illness and the plague was still to be feared. Such was life before 1928, the year Alexander Fleming revolutionised the field of medicine by accidentally discovering penicillin, a mould which could kill bacteria. This drug became the world’s first antibiotic and it spurred scientists to discover other classes of antimicrobial compounds, which together dramatically reduced the spread of disease. However, this golden era of medicine will not last forever. After only a few years of use, disease-causing bacteria had emerged which were resistant to antibiotics. The most common of these so-called “superbugs”, methicillin-resistant Staphylococcus aureus (MRSA), is now responsible for an increasing number of deaths, and is practically untreatable. Similarly, incidents of multi- drug-resistant tuberculosis are on the rise. Other drug-resistant bacteria are ...

Exploring patient-provider factors for risk of developing Multi-drug Resistance Tuberculosis in Southern Ethiopia: Qualitative Operation Research (Preprint)

2019 ◽  
Author(s):  
Yitagesu Habtu ◽  
Tesema Bereku ◽  
Girma Alemu ◽  
Ermias Abera
Keyword(s):  
Phenomenological Study ◽  
Treatment Success ◽  
World Health ◽  
Multi Drug Resistance ◽  
Southern Ethiopia ◽  
Drug Resistant ◽  
Related Factors ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis

BACKGROUND Ethiopia is one of among thirty high burden countries of multi-drug resistant tuberculosis (MDR-TB) in the regions of world health organization. Contextual evidence on the emergence of the disease is limited at a program level. OBJECTIVE The aim of the study is to explore patient-provider factors that may facilitate the emergence of multi-drug resistant tuberculosis. METHODS We used a phenomenological study design of qualitative approach from June to July, 2015. We conducted ten in-depth interviews and 4 focus group discussions with purposely selected patients and providers. We designed and used an interview guide to collect data. Verbatim transcribes were exported to open code 3.4 for emerging thematic analysis. Domain summaries were used to support core interpretation. RESULTS The study explored patient-provider factors facilitating the emergence of multi-drug resistant tuberculosis. These factors as underlying, health system and patient-related factors. Especially, the a shows conflicting finding between having a history of discontinuing drug-susceptible tuberculosis and emergence of multi-drug resistant tuberculosis. CONCLUSIONS The patient-provider factors may result in poor early case identification, adherence to and treatment success in drug sensitive or multi-drug resistant tuberculosis. Our study implies the need for awareness creation about multi-drug resistant tuberculosis for patients and further familiarization for providers. This study also shows that patients developed multi-drug resistant tuberculosis though they had never discontinued their drug-susceptible tuberculosis treatment. Therefore, further studies may require for this discording finding.

scholarly journals Determinants Of Multidrug Resistant Tuberculosis Among Adultsundergoing Treatment For Tuberculosis In Tigray Region, Ethiopia: A Case Control Study

2019 ◽  
Author(s):  
Kidane Zereabruk ◽  
Tensay Kahsay ◽  
Hiyab Teklemichael ◽  
Woldu Aberhe ◽  
Abrha Hailay ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Multi Drug Resistance ◽  
P Value ◽  
Rural Residence ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Tigray Region ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis

Abstract Background Multidrug-resistant tuberculosis is a type of tuberculosis that is resistant to at least the first line anti-tuberculosis drugs namely, Rifampicin and Isoniazid. Multidrug-resistant tuberculosis has continued to be a challenge for tuberculosis control globally. Globally 600,000 people were newly eligible for Multidrug-resistant tuberculosis treatment with an estimated 240,000 deaths annually. There are few numbers of multi drug resistant tuberculosis studies in different regions of Ethiopia. However, most of these studies were restricted only to a single hospital and there is no published information regarding multi drug resistant tuberculosis in Tigray region. Therefore, the aim of this study was to assess the determinants of multidrug resistant tuberculosis among adults undergoing treatment for tuberculosis in Tigray region, Ethiopia.Methods A hospital based unmatched case control study was conducted from April to June, 2019. Simple random sampling method was used to select 85 cases and 169 controls. Primary data was collected by face-to-face interview and secondary data by reviewing patients’ charts using pretested structured questionnaires. The data were entered and cleaned using Epi data manager then exported to SPSS for analysis. Binary Logistic regression model was used to test the association between independent and dependent variables. Model fitness was checked using Hosmer-Lemeshow goodness-of-fit and Variance inflation factor was used to assess multi collinearity between the independent variables. Variables at p-value less than 0.25 in bivariate analysis was entered into a multivariable analysis to identify the determinant factors of multi drug resistant tuberculosis. Finally, level of significance was declared at p-value <0.05.Results A total of 254 participants with 85 cases and 169 controls were included in this study. Of the respondents, 62 (36.7%) among the controls and 48 (56.5%) among the cases were living in rural residence. Rural residence [AOR=2.54;95%CI=1.34,4.83], HIV[AOR=4.5;95%CI=1.4,14.2], relapse [AOR=3.86;95%CI;1.98,7.5], return after lost follow up [AOR=6.29;95% 1.64,24.2], treatment failure [AOR=5.87; CI=1.39,24.8] were among the determinants of Multi drug resistance tuberculosis.Conclusion Rural residence, HIV, relapse, return after lost follow up and treatment failure were the identified determinant factors of Multi drug resistance tuberculosis.

scholarly journals RAPID DETECTION OF MULTI DRUG RESISTANCE AMONG MULTI DRUG RESISTANT TUBERCULOSIS SUSPECTS USING LINE PROBE ASSAY

2016 ◽  
Vol 10 (1) ◽  
pp. 131
Author(s):  
Sanjeev Saini ◽  
Manoj Kumar Dubey ◽  
Uma Bhardwaj ◽  
M Hanif ◽  
Chopra Kk ◽  
...  
Keyword(s):  
Fluorescent Microscopy ◽  
Multi Drug Resistance ◽  
Sputum Smear ◽  
Drug Resistant ◽  
Line Probe Assay ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Probe Assay

ABSTRACTObjective: GenoType MTBDRplus line probe assay (LPA) is developed for performing drug susceptibility testing (DST) for Rifampicin (RIF) andisoniazid in sputum specimens from smear-positive pulmonary tuberculosis (TB) patients and revised national TB control Programme (RNTCP)has endorsed LPA for the diagnosis of multi drug resistant TB (MDR-TB). This study was conducted to assess the potential utility of LPA for MDR-TBpatient management.Methods: MDR-TB suspects under RNTCP PMDT criteria C referred from different districts in Delhi state were included in the study January 2013 toDecember 2014. Sputum specimens found acid-fast bacilli positive by fluorescent microscopy were processed for LPA.Results: Out of 3062 specimens, 2055 (67.1%) MDR-TB suspects were read as positive and specimens from 1007 (32.9%) suspects were read asnegative in sputum smear microscopy. Out of 2019 specimens valid LPA results, 1427 were found to be pan-sensitive, 280 were MDR-TB, 40 were RIFmonoresistant, 183 were Isoniazid (INH) monoresistant, and 89 specimens were found negative for Mycobacterium tuberculosis.Conclusion: Routine use of LPA can substantially reduce the time to diagnosis of RIF and/or INH-resistant TB and can hence potentially enable earliercommencement of appropriate drug therapy and thereby facilitate prevention of further transmission of drug resistant strains.Keywords: Multi drug resistant tuberculosis, Line probe assay, Rifampicin, Isoniazid.

scholarly journals A study on multi drug resistant tuberculosis at Sree Mookambika Institute of Medical Sciences

2017 ◽  
Vol 4 (9) ◽  
pp. 3234
Author(s):  
Prashant V. Solanke ◽  
Preeti Pawde ◽  
Ajin R. M.
Keyword(s):  
Drug Resistance ◽  
Mycobacterium Tuberculosis ◽  
Sputum Culture ◽  
Multi Drug Resistance ◽  
Drug Resistant ◽  
Medical Sciences ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb

Background: Tuberculosis (TB) is one of the major causes of morbidity and mortality worldwide. Resistance to antitubercular drugs has been noted since the drugs were first introduced, and occasionally outbreaks of drug-resistant tuberculosis have been reported worldwide. WHO emphasizes that good TB control prevents the emergence of drug resistance in the first place and that the proper treatment of multi-drug resistant tuberculosis prevents the emergence of XDR-TB. The objectives of the study were to examine the sputum samples regarding MDR-TB, to study the grading regarding sputum positive and to study the multi-drug resistance tuberculosis in Sree Mookambika Institute of Medical sciences.Methods: Study design was cross-sectional, Study duration was January 2016-March 2017. Study place was Sree Mookambika Institute of Medical Sciences Hospital, Kulasekharam. Sample size was 400. Data entered in MS-Office Word- 2016. Institutional ethical committee clearance was obtained. Results: In present study 54.86% patient had sputum AFB positive, 45.13% had sputum AFB negative smears. 75% of the sputum AFB positive pulmonary TB came under the age group between 20-60 and 25% above 60 yrs. 78.24% males, 21.75% females had sputum AFB smear positive pulmonary tuberculosis and 43.73% patients had positive sputum culture, 56.26% patients had negative sputum culture and the most common strain found was Mycobacterium tuberculosis. Conclusions: So from our study we found that Mycobacterium tuberculosis is the major strain isolated from sputum samples. The resistance is more to Isoniazid and Rifampicin and is more in the rural parts of India. Early screening and drug susceptibility test of culture positive and MTB cases will help in initiating treatment of MDR-TB. 

scholarly journals Drug Resistant Tuberculosis in the Northern Region of Zambia: A Retrospective Study

2021 ◽  
Vol 2 ◽  
Author(s):  
Ngula Monde ◽  
Mildred Zulu ◽  
Mathias Tembo ◽  
Ray Handema ◽  
Musso Munyeme ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Susceptibility Testing ◽  
Drug Susceptibility ◽  
Drug Susceptibility Testing ◽  
Multi Drug Resistance ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Tuberculosis Patients ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis

BackgroundZambia like many countries in sub-Saharan Africa is affected with drug resistant tuberculosis. However, the drug resistant tuberculosis situation over the years has not been described in various regions of the country. Consequently, this study aims to determine the drug resistant tuberculosis burden in northern regions of Zambia over a four-year period based on data generated from a Regional Tuberculosis Reference Laboratory.MethodTwo hundred and thirty two (232) Tuberculosis Drug Susceptibility Testing results over a four-year period (2016-2019) were reviewed. Data was collected from tuberculosis registers and patient request forms and entered into a pre-tested standardized checklist and later entered in Excel Computer software. Double blinded checking was done by two independent data clerks to minimize duplication of cases. Cleaned data was then imported in R programme for analysis. Bivariant and descriptive statistics were performed and reported.ResultsOf 232 Drug Susceptibility Testing results, 90.9% were drug resistant TB while 9% were drug susceptible. Fifty three percent (53%) of these were multi-drug resistant Tuberculosis and 32% were confirmed as Rifampicin Mono-resistance. Only 1.7% of the Multi-drug resistant Tuberculosis patients were Pre-extensively drug-resistant Tuberculosis. Copperbelt province had the largest proportion (46.0%) of multi-drug resistant tuberculosis patients followed by Luapula (8.1%) and North-Western (4.7%) provinces. In new and previously treated patients, the proportion of Multi-drug resistant tuberculosis was 71.8% and 28.7% respectively. History of previous anti-tuberculosis treatment and treatment failure were associated with multi-drug resistance TB.Conclusion and RecommendationThis study has shown a small increase in the proportions of drug resistant tuberculosis cases over the four years under review with high rates being recorded on the Copperbelt Province. Previous treatment to first line TB treatment and treatment failure were associated with development of Multi-drug resistance. We therefore recommend strengthened routine laboratory surveillance and improved case management of multi-drug resistant tuberculosis patients in the region.

scholarly journals Determinants Of Multidrug Resistant Tuberculosis Among Adults Undergoing Treatment For Tuberculosis In Tigray Region, Ethiopia: A Case Control Study

2019 ◽  
Author(s):  
Kidane Zereabruk ◽  
Tensay Kahsay ◽  
Hiyab Teklemichael ◽  
Woldu Aberhe ◽  
Abrha Hailay ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Multi Drug Resistance ◽  
P Value ◽  
Rural Residence ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Tigray Region ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis

Abstract Background Multidrug-resistant tuberculosis is a type of tuberculosis that is resistant to at least the first line anti-tuberculosis drugs namely, Rifampicin and Isoniazid. Multidrug-resistant tuberculosis has continued to be a challenge for tuberculosis control globally. Globally 600,000 people were newly eligible for Multidrug-resistant tuberculosis treatment with an estimated 240,000 deaths annually. There are few numbers of multi drug resistant tuberculosis studies in different regions of Ethiopia. However, most of these studies were restricted only to a single hospital and there is no published information regarding multi drug resistant tuberculosis in Tigray region. Therefore, the aim of this study was to assess the determinants of multidrug resistant tuberculosis among adults undergoing treatment for tuberculosis in Tigray region, Ethiopia.Methods A hospital based unmatched case control study was conducted from April to June, 2019. Simple random sampling method was used to select 85 cases and 169 controls. Primary data was collected by face-to-face interview and secondary data by reviewing patients’ charts using pretested structured questionnaires. The data were entered and cleaned using Epi data manager then exported to SPSS for analysis. Binary Logistic regression model was used to test the association between independent and dependent variables. Model fitness was checked using Hosmer-Lemeshow goodness-of-fit and Variance inflation factor was used to assess multi collinearity between the independent variables. Variables at p-value less than 0.25 in bivariate analysis was entered into a multivariable analysis to identify the determinant factors of multi drug resistant tuberculosis. Finally, level of significance was declared at p-value <0.05.Results A total of 254 participants with 85 cases and 169 controls were included in this study. Of the respondents, 62 (36.7%) among the controls and 48 (56.5%) among the cases were living in rural residence. Rural residence [AOR=2.54;95%CI=1.34,4.83], HIV[AOR=4.5;95%CI=1.4,14.2], relapse [AOR=3.86;95%CI;1.98,7.5], return after lost follow up [AOR=6.29;95% 1.64,24.2], treatment failure [AOR=5.87; CI=1.39,24.8] were among the determinants of Multi drug resistance tuberculosis.Conclusion Rural residence, HIV, relapse, return after lost follow up and treatment failure were the identified determinant factors of Multi drug resistance tuberculosis.

scholarly journals Bedaquiline as part of combination therapy in adults with pulmonary multi-drug resistant tuberculosis

2016 ◽  
Vol 9 (8) ◽  
pp. 1025-1037 ◽  
Author(s):  
T. V. A. Nguyen ◽  
T. B. T. Cao ◽  
O. W. Akkerman ◽  
S. Tiberi ◽  
D. H. Vu ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis
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