Efficiency of intravenous treatment with levofloxacin in patients with MDR pulmonary tuberculosis in the intensive phase of chemotherapy

Background: Many diseases are associated with smoking such as malignant disease, cardiovascular, diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), arthritis, impotence, infertility, Alzheimer’s Disease, tuberculosis and others. Smoking is proven to disrupt the ciliary mucosal clearance and it is associated with an increased risk of pulmonary tuberculosis. Sputum conversion is an important indicator to assess the success of TB treatment. This study aims to determine the relation between smoking history and the success intensive phase treatment of pulmonary tuberculosis at Dr Zainoel Abidin Hospital. Method: Prospective cohort study in patients with pulmonary tuberculosis acid-fast bacilli (AFB) positive (+) smokers and non smokers who visited the Integrated Tuberculosis Care (PTT), at outpatient and inpatient pulmonary infection RSU Dr. Zainoel Abidin hospital Banda Aceh from 28 November 2015 until 1 February 2016. Results: A total of 38 subjects were divided into 2 groups (19 subjects with 19 subjects smokers and non-smokers). All subjects smokers are male while nonsmoker subjects consisted of male and female. The results of the first month study (p=0.009), there are 14 non smoker subjects with AFB conversion (73,7%) and 5 subjetcs without AFB conversion. Among smoking subjects there are 6 subjets (31.6%) with AFB conversion and 13 subjects (68.4% ) without AFB conversion. In the second month (p=0,202), more than half subjects who are non-smokers had AFB conversion, 17 subjects (89.5%) and 2 subjects (10.5%) had no AFB conversion. In smokers group there are 14 subjects (73.7% ) had AFB conversion and 5 subject (26.3%) had no conversion. Conclusion: There was a significant relation between smoking habit and the occurrence of first-month AFB sputum. (J Respir Indo. 2018; 38: 232-8)

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Clinical, laboratory and radiological associations with extending of the intensive phase of treatment in patients with first diagnosed infiltrative pulmonary tuberculosis

ScienceRise Medical Science ◽

10.15587/2519-4798.2021.246236 ◽

2021 ◽

pp. 15-19

Author(s):

Vasyl Kushnir

Keyword(s):

Pulmonary Tuberculosis ◽

Clinical Laboratory ◽

Therapy Group ◽

Hospital Setting ◽

Blood Concentrations ◽

Intensive Phase ◽

Number Of Patients ◽

Before And After ◽

Group 2 ◽

Group 1

Despite the availability of medical services, timely detection of pulmonary tuberculosis, before the appearance of destructive changes, is often difficult. The management of patients with an infiltrative form in a hospital setting does not always guarantee the same positive effect and sometimes requires prolongation of therapy. The effectiveness of therapy can be associated with various factors and is of interest to study. The aim of this work was to study the effectiveness of standard therapy in patients with first diagnosed infiltrative pulmonary tuberculosis, clinical laboratory and radiological associations with prolongation of the intensive phase of treatment. Materials and methods. The study involved 109 men from 18 to 53 years old with first diagnosed infiltrative pulmonary tuberculosis with preserved MBT sensitivity to 1-st line anti-tuberculosis drugs. Patients were examined before and after 60 doses of the intensive phase of treatment, after which two groups were formed. Group 1 included patients with pronounced positive clinical and radiological dynamics, who entered the continuation phase of therapy. Group 2 included patients with insufficient clinical and radiological dynamics, for whom the intensive phase of treatment was extended to 90 doses. Results. Weak dynamics in patients who needed prolongation of treatment was associated with the characteristics of the initial data of patients in this group compared with similar indicators in Group 1. These were a reliably higher frequency of symptoms of intoxication and coughing, a reliably greater number of patients excreting mycobacterium tuberculosis in large quantities in sputum, with reliably high blood concentrations of haptoglobin and ceruloplasmin levels. Conclusions. Patients requiring prolongation of the intensive phase of treatment are characterized by an initially higher prevalence of infiltrative changes in the lungs, a small number of lung lesions limited to 2 segments, the presence of destructive changes in 100 % of cases, and a significant increase in the factors of the systemic inflammatory response

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IMPACT OF TUBERCULOSIS AND ANTITUBERCULOUS CHEMOTHERAPY ON LIPID COMPOSITION OF THE BLOOD PLASMA

Epidemiology and Infectious Diseases (Russian Journal) ◽

10.18821/1560-9529-2018-23-5-220-224 ◽

2018 ◽

Vol 23 (5) ◽

pp. 220-224

Author(s):

Dmitri Sergeevich Riasensii ◽

N. A. Grishkina ◽

A. V. Aseev

Keyword(s):

Lipid Metabolism ◽

Pulmonary Tuberculosis ◽

Blood Plasma ◽

Plasma Lipids ◽

Phospholipid Composition ◽

Plasma Lipid ◽

Aged Patients ◽

Intensive Phase ◽

Lipid Spectrum ◽

Antituberculous Chemotherapy

Tuberculosis is an infectious disease caused by tuberculosis mycobacteria of human or bovine types and is characterized by multiple organs failure and chronic recurrent course. The blood plasma lipid spectrum state is one of the antituberculous chemotherapy toxic effect markers. The important role of the ratio of various fractions of general and blood phospholipids for the evaluation of the state of the organism in infectious pathology is proved. The purpose of this work is to study the features of the lipid spectrum of blood plasma in patients with pulmonary tuberculosis prior to treatment and at the end of the intensive phase of antituberculous chemotherapy. Three hundred and eight young and middle-aged patients with pulmonary tuberculosis were examined. The lipid and phospholipid spectrum of blood was determined prior to initiating the antituberculous chemotherapy and after the end of the intensive phase. The absolute content of general lipids and total phospholipids of blood plasma, as well as all their fractions, in patients with pulmonary tuberculosis were higher than in healthy volunteers. In this regard, the representation of the lipid spectrum in absolute units does not reflect all the features of lipid metabolism disruption, which is primarily manifested in the plasma lipids main classes ratio violation. It is shown that the spectrum of lipid and phospholipid composition of blood plasma in patients with pulmonary tuberculosis differs significantly from the spectrum in healthy people. Antituberculous chemotherapy with bactericidal and bacteriostatic action comes with normalization of a number of lipid metabolism indicators such as free fatty acids, triglycerides, cholesterol esters and phosphatidylserine. However, such indicators as total phospholipids, free cholesterol and lysophospholipids show negative dynamics, which is probably caused by the antituberculous drug’s effect.

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Trends in sputum smear conversion among smear-positive pulmo-nary tuberculosis patients

Journal of Medical and Biomedical Sciences ◽

10.4314/jmbs.v4i1.4 ◽

2015 ◽

Vol 4 (1) ◽

pp. 24-33

Author(s):

SEK Acquah ◽

L Quaye ◽

W Walana ◽

EK Vicar ◽

YN Osei ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Significant Proportion ◽

Response To Therapy ◽

Sputum Smear ◽

Patient Response ◽

Important Indicator ◽

Intensive Phase ◽

Tuberculosis Patients ◽

Conversion Rates

Sputum smear conversion during pulmonary tuberculosis treatment is an important indicator of patient response to therapy and as such determines the direction of TB patient care. This retro-spective review assessed the trends in sputum smear evaluation and conversion rates among follow up pulmonary tuberculosis patients presenting to the Tamale Teaching Hospital from January 2004 to December 2012. A total of 8,238 sputum smear cases comprising of 6,892 (83.7%) diagnoses and 1,346 (16.3%) follow-up cases were recorded. The 1,346 follow-up cases comprised of 57.8% (778/1346) males and 42.2% (568/1346) females. The percentage proportion of follow up cases that had their month of follow up, residential addresses, ages and smear results reported are 93.8% (1262/1346), 95.2% (1281/1346), 98.2% (1322/1346) and 97.8% (1309/1346) respectively. The cumula-tive median age was 43years (IQR: 30 to 55years) with the minimum and maximum ages being 14 and 80 years recorded in 2008 and 2012 respectively. Thirty eight percent (511/1,346) of follow-up cases were from the intensive phase (month 2) evaluation period. One hundred and eleven (111) of the follow up cases were smear positive representing a cumulative positivity rate of 8.5% (111/1309). This comprised of 75(67.6 %) males and 36(32.4%) females. Generally males were observed to be significantly more likely to delay smear conversion during treatment (OR = 1.560; p = 0.035, 95% CI=1.032- 2.359) compared to females. The ages of the positive cases ranged from 14 to 75 years with a median age of 45.5 years. The intensive phase (month 2) positivity rate was 8.1% (63/776) representing a conversion rate of 91.9%. Significant proportion (15.4%) of males were smear posi-tive and were more likely to remain positive after two months of therapy compared to their female counterparts (OR = 2, p = 0.02, CI = 0.098 – 1.299). Periodic surveillance of regional sputum smear late/non conversion among PTB patients on treatment would be useful in supporting Tb manage-ment in Ghana.Keywords: Mycobacterium tuberculosis, follow up, microscopy, acid fast bacilli, Ghana

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DRUGS CONTAINING GLYCYRRHIZIC ACID IN COMPLEX THERAPY FOR PULMONARY TUBERCULOSIS

Epidemiology and Infectious Diseases (Russian Journal) ◽

10.18821/1560-9529-2019-24-3-118-122 ◽

2019 ◽

Vol 24 (3) ◽

pp. 118-122

Author(s):

Dmitrii Sergeevich Riasenskii ◽

N. A. Grishkina ◽

A. V. Aseev

Keyword(s):

Pulmonary Tuberculosis ◽

Glycyrrhizic Acid ◽

Mononuclear Cells ◽

The State ◽

Licorice Root ◽

Peripheral Blood Mononuclear ◽

Intensive Phase ◽

Phospholipid Ratio ◽

Tuberculosis Chemotherapy ◽

Specific Correction

The effectiveness of etiotropic chemotherapy is largely determined by the tolerability o the TB drugs (TBD) and the severity of unwanted side effects. It is known about the immunopathological effect of TBD, which can also be attributed to the undesirable effects of anti-tuberculosis chemotherapy. Changes in the structure and composition of mononuclear membranes reflect their functional activity. Secondary disorganization of the lipid bilayer due to the action of TBD is an important element in the development of immunosuppressive conditions in pulmonary tuberculosis and requires specific correction. The paper has the results of a survey of 308 patients with tuberculosis included. The comparison group consisted of 36 healthy volunteers. The membrane destruction coefficient and cholesterol-phospholipid ratio were used in order to assess the state of peripheral blood mononuclear cells and the degree of structural disorganization of their membranes. The prescription of preparations containing glycyrrhizic acid is pathogenetically substantiated and allows improving the state of the membranes of mononuclear cells, thereby reducing the undesirable membrane-toxic effect of first-line anti-tuberculosis drugs, There was an increase in etiotropic therapy intensity on the basis of abacilation at the end of the intensive phase of the main course of chemotherapy from 61% to 72.4% when using Licorice Root, and to 81.3% when using Fosfogliv® in patients with focal and infiltrative pulmonary tuberculosis.

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