scholarly journals Adverse events among patients of multi drug resistant tuberculosis receiving second line anti TB treatment

2015 ◽  
Vol 1 (6) ◽  
pp. 253 ◽  
Author(s):  
Kishor B. Rathod ◽  
Mangala S. Borkar ◽  
Avinash R. Lamb ◽  
Sanjay L. Suryavanshi ◽  
Gajanan A. Surwade ◽  
...  
Keyword(s):  
Adverse Events ◽  
Adverse Drug Reactions ◽  
High Protein Diet ◽  
Drug Resistant ◽  
Second Line ◽  
Drug Reactions ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Poor Treatment ◽  
Mdr Tb

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>As per WHO’s “Global Tuberculosis Report, 2012”, India accounts for an estimated 64000 patients out of 310000 cases of drug resistant TB estimated to have occurred amongst the notified cases of TB across the globe in a year. <strong> </strong><span lang="EN-US">MDR-TB is a man-made phenomenon– poor treatment; poor drugs, poor adherence lead to the development of MDR-TB. </span><span lang="EN-US"> </span><span lang="EN-US">Treatment of MDR-TB is difficult, much costlier, challenging and needs experience and skills. Reserve drugs are frequently associated with high rates of unacceptable adverse drug reactions, needing change of regimen. Therefore, it is imperative to monitor and treat adverse drug reactions. <strong></strong></span></p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>The present prospective observational study was carried out at Drug Resistant Tuberculosis Centre at Govt. Medical College, Aurangabad, Maharashtra, to monitor patients for early detection of adverse events after starting treatment till the patients were admitted and later followed up personally or telephonically at regular intervals.</p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong><span lang="EN-US"> We observed adverse drug reactions among </span>90/265 (33.96 %) patients of whom 90/265 (33.96 %) had gastro intestinal ADRs, followed by ototoxicity 15/265 (5.66%), psychiatric manifestations 14/265 (5.28%), injection site pain swelling 13/265 (4.90%), arthralgia 11/265 (4.15%), dermatological ADRs 7/265 (2.64%), peripheral neuropathy 5/265 (1.88%), renal dysfunction 3/265 (1.13%), <span lang="EN-US">change of therapy was only required in 13 psychiatric and 12 ototoxic ADRs.</span></p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong><span lang="EN-US"> ADRs are more common in MDR TB patients on second line anti tubercular treatment. Good counseling, spacing drugs, high protein diet helps patients to tolerate therapy better and default rate to drop.</span></p>

scholarly journals Adverse Drug Reactions in Patients put on Multi Drug Resistant Tuberculosis (MDR-TB) Treatment in Seven Districts of Central Gujarat

2015 ◽  
Vol 7 (4s) ◽  
pp. 425-431 ◽  
Author(s):  
Sangita Vashrambhai Patel ◽  
Nimavat Kapil Bhikhubhai ◽  
Alpesh Bhimabhai patel ◽  
Kalpita Samrat Shringarpure ◽  
Kedar Gautambhai Mehta ◽  
...  
Keyword(s):  
Adverse Drug Reactions ◽  
Drug Resistant ◽  
Drug Reactions ◽  
Drug Resistant Tuberculosis ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb

scholarly journals A study of adverse drug reactions in patients receiving treatment for multi-drug resistant tuberculosis

2017 ◽  
Vol 6 (2) ◽  
pp. 354
Author(s):  
Mayur P. Shinde ◽  
Nimish R. Halasawadekar ◽  
Sunita J. Ramanand ◽  
Shraddha M. Pore ◽  
Jayprakash B. Ramanand ◽  
...  
Keyword(s):  
Early Detection ◽  
Adverse Drug Reactions ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Resistant ◽  
Drug Reactions ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb

Background: A high frequency of adverse drug reactions (ADRs) is one of the major challenges in the treatment of Multi-drug resistant tuberculosis (MDR-TB). Patients may refuse to continue treatment if ADRs are not properly addressed, drugs may be stopped unnecessarily and treatment may be terminated prematurely by inexperienced health workers, resulting in a high proportion of failure.Methods: Patients diagnosed for MDR-TB and registered in Drug Resistant TB centre (DR-TB) of tertiary care hospital during period of July 2014 to June 2015 were enrolled in the study. Data of patients hospitalized for the complaints of ADR in DR-TB centre during study period was collected.Results: Out of 468 patients, 60 (12.82%) patients developed at least one adverse reaction and were hospitalised for the same. Among 109 reported ADRs, Gastrointestinal upset was the most common ADR reported (5.98%) followed by psychosis (4.91%) and ototoxicity (2.99%).Conclusions: The health providers, the patients and their relatives should be sensitised about these ADRs for early detection and treatment. It can also be suggested that the setup of DR-TB centre should be integrated with psychiatry and ENT specialities, with all the provisions of early detection of ADR and treatment.

scholarly journals A STUDY ON LIVER FUNCTION TEST PROFILE OF 2ND LINE DRUGS IN MULTI DRUG RESISTANT (MDR) AND EXTENSIVELY DRUG RESISTANT (XDR) TUBERCULOSIS CASES REGISTERED UNDER DR-TB CENTRE IN A TERTIARY CARE HOSPITAL

2020 ◽  
pp. 1-3
Author(s):  
Rupam Kumar Ta ◽  
Pronoy Sen
Keyword(s):  
Adverse Drug Reactions ◽  
Initial Period ◽  
Care Hospital ◽  
Drug Resistant ◽  
Drug Reactions ◽  
Drug Resistant Tuberculosis ◽  
Intensive Phase ◽  
Tb Control ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant

BACKGROUND: The emergence of drug resistant mycobacterium has become a signicant public health problem creating an obstacle to effective Tuberculosis (TB) control. Freedom from TB is possible with timely, regular, complete treatment, with assurance, prevention and management of side effects of antitubercular drugs. Present study was conducted to evaluate common and rare adverse drug reactions (ADR) of CAT IV and CAT V to analyse demographic, radiological and bacteriological prole and treatment outcome in MDR &XDR patients. Aims and Objectives- To evaluate the common and rare adverse drug reactions of intensive phase treatment of Multi Drug Resistant Tuberculosis (MDR) and Extensively Drug Resistant Tuberculosis (XDR) as per WHO-UMC Causality Assessment Scale. METHODS: 76 patients of MDR and XDR Tuberculosis were admitted in DR-TB (Drug Resistant TB) centre, Burdwan Medical College and Hospital and the adverse drug reaction prole of 2nd line drugs were analysed during the intensive phase for a year after fullling the inclusion and exclusion criteria. Treatment was given as per guidelines by Revised National TB Control Program PMDT (Programmatic management of drug-resistant TB). RESULTS:Adverse drug reactions on GI system were nausea 73 patients (96.10%), vomiting 70 (92.10%), acidity 41 (53.9%), and sulphurous belching and hepatitis 1 (1.31%) each. CONCLUSIONS: The reactions were common in rst 60 days of the regimen and in patients with BMI ≤18. Hence vigilant monitoring is required for these types of patients during the initial period and sputum smear and culture conversion is very well correlated with clinical and radiological improvement.

scholarly journals SIDE EFFECTS ASSOCIATED WITH DRUGS USED IN TREATMENT OF MULTI DRUG RESISTANT TUBERCULOSIS AND TREATMENT RELATED FACTORS OF MULTI DRUG RESISTANT TUBERCULOSIS PATIENTS IN KATHMANDU VALLEY

2017 ◽  
Vol 14 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Chandra Prakash Bhatt ◽  
B KC
Keyword(s):  
Health Care ◽  
Side Effects ◽  
Drug Resistant ◽  
Second Line ◽  
Related Factors ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Care Worker

Introduction: Treatment of multi drug resistant Mycobacterium tuberculosis (MDR-TB) with second line drugs is associated with adverse drug reactions and toxicity. Aim of this study were to determine side effects associated with drugs used in treatment of multi drug resistant tuberculosis and treatment related factors of MDR-TB patients.Methodology: A prospective study was carried out in National Tuberculosis Centre Bhaktapur Nepal. Questionnaires were used to collect data from patients.Results: Total 101 MDR TB patients were included among them majorities were male (52%) and mean age of the patients was 31.2 years. Majority of patients (87.1%) had previous history of tuberculosis treatment and 54.5% were in intensive phase of treatment. The side effect associated with drugs used in treatment of MDR-TB reported by patients were joint pain (21.2%), nausea (20.3%), hearing disturbances (11%), gastrointestinal disturbance (9.9%), depression (9.6%), itching (8.1%), hypothyroidism (6.4%), dizziness (6.4%), seizures (3.8%) and hepatitis (3.5%). Last month 25.74% patients missed one or more doses of drugs and 3.9% missed drug doses due to side effect of drugs. Majorities of the patients used vehicle to reach health centre (92.07%), time to reach the health center (59.4%) were less than 30 minutes but majorities of patients (57.4%) were not satisfied by the counseling of health care worker.Conclusion: The finding of this study shows that in MDR patients 12.8% were found new cases. Last month 3.9% patients were stopped the drugs due to side effects of drugs. Majority of patients (57.4%) were not satisfied by counseling of health care worker. Treatment of multi drug resistant tuberculosis with second line anti tubercular drugs is associated with side effects, health care worker counseling to MDR- TB patients with full attention is essential to encourage the patient’s moral and complete the treatment. Timely managing the side effects of medication is important in helping people to complete their treatment.SAARC J TUBER LUNG DIS HIV/AIDS, 2017; XIV(1), Page: 1-6

scholarly journals Treatment of Drug-Resistant Tuberculosis: Current Status

2020 ◽  
Author(s):  
Rajendra Prasad ◽  
Harsh Saxena ◽  
Nikhil Gupta ◽  
Mohammad Tanzeem ◽  
Ronal Naorem
Keyword(s):  
Total Duration ◽  
World Health ◽  
Current Status ◽  
Current Evidence ◽  
Drug Resistant ◽  
Second Line ◽  
Drug Resistant Tuberculosis ◽  
Intensive Phase ◽  
Resistant Tuberculosis ◽  
Mdr Tb

AbstractDrug-resistant tuberculosis (DR-TB) has been an area of growing concern and posing threat to human health worldwide. The treatment has been defined for all types of DR-TB with or without newer anti-TB drugs. multi-DR-TB (MDR-TB) patients have now choice of two types of regimen, shorter and longer regimens. Shorter regimen for treatment of subset of MDR-TB patients who have not been previously treated with second line drugs and in whom resistance to fluoroquinolones and second-line injectable agents has been excluded is given for 9 to 11 months. A longer regimen of at least five effective anti-TB drugs (ATDs) during the intensive phase is recommended, including pyrazinamide and four core second-line ATDs. Intensive phase, including injectables, should be given for at least 8 months. The total duration of treatment is at least 20 months, which can be prolonged up to 24 months depending on the response of the patient. World Health Organization (WHO) has recently revised the grouping of ATD for use in DR-TB patients in 2018 into three groups based on individual patient data meta-analysis depending on their individual efficacy, risk of relapse, treatment failure, and death. Recently, an all oral longer regimen comprising bedaquiline, pretomanid, and linezolid (BPal regime) for 6 to 9 months for extensive-DR-TB (XDR-TB) patients and those MDR-TB patients who cannot tolerate or do not respond to conventional MDR-TB regimen. These new developments will be a step forward toward establishing universal regimen to treat all types of DR-TB. This article has summarized the current evidence from literature search to date, including prevalence of DR-TB, types of regimen used and the advancement in the regimens for effective treatment of DR-TB patients.

scholarly journals Cost comparison of nine-month treatment regimens with 20-month standardized care for the treatment of rifampicin-resistant/multi-drug resistant tuberculosis in Nigeria

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0241065
Author(s):  
Florence O. Bada ◽  
Nick Blok ◽  
Evaezi Okpokoro ◽  
Saswata Dutt ◽  
Christopher Akolo ◽  
...  
Keyword(s):  
Treatment Regimen ◽  
Treatment Success ◽  
Cost Savings ◽  
Drug Resistant ◽  
Second Line ◽  
Success Rates ◽  
Drug Resistant Tuberculosis ◽  
Treatment Regimens ◽  
Resistant Tuberculosis ◽  
Mdr Tb

Background Globally, drug resistant tuberculosis (DR-TB) continues to be a public health threat. Nigeria, which accounts for a significant proportion of the global burden of rifampicin/multi-drug resistant-TB (RR/MDR-TB) had a funding gap of $168 million dollars for TB treatment in 2018. Since 2010, Nigeria has utilized five different models of care for RR/MDR-TB (Models A-E); Models A, B and C based on a standardized WHO-approved treatment regimen of 20–24 months, were phased out between 2015 and 2019 and replaced by Models D and E. Model D is a fully ambulatory model of 9–12 months during which a shorter treatment regimen including a second-line injectable agent is utilized. Model E is identical to Model D but has patients hospitalized for the first four months of care while Model F which is to be introduced in 2020, is a fully ambulatory, oral bedaquiline-containing shorter treatment regimen of 9–12 months. Treatment models for RR/MDR-TB of 20–24 months duration have had treatment success rates of 52–66% while shorter treatment regimens have reported success rates of 85% and above. In addition, replacing the second-line injectable agent in a shorter treatment regimen with bedaquiline has been found to further improve treatment success in patients with fluoroquinolone-susceptible RR/MDR-TB. Reliable cost data for RR/MDR-TB care are limited, specifically costs of models that utilize shorter treatment regimens and which are vital to guide Nigeria through the provision of RR/MDR-TB care at scale. We therefore conducted a cost analysis of shorter treatment regimens in use and to be used in Nigeria (Models D, E and F) and compared them to three models of longer duration utilized previously in Nigeria (Models A, B and C) to identify any changes in cost from transitioning from Models A-C to Models D-F and opportunities for cost savings. Methods We obtained costs for TB diagnostic and monitoring tests, in-patient and out-patient care from a previous study, inflated these costs to 2019 NGN and then converted to 2020 USD. We obtained other costs from the average of six health facilities and drug costs from the global drug facility. We modeled treatment on strict adherence to two Nigerian National guidelines for programmatic and clinical management of drug-resistant tuberculosis. Results We estimated that the total costs of care from the health sector perspective for Models D, E and F were $4,334, $7,705 and $3,420 respectively. This is significantly lower than the costs of Models A, B and C which were $14,781, $12, 113, $7,572 respectively. Conclusion Replacing Models A–C with Models D and E reduced the costs of RR/MDR-TB care in Nigeria by approximately $5,470 (48%) per patient treated and transitioning from Models D and E to Model F would result in further cost savings of $914 to $4,285 (21 to 56%) for every patient placed on Model F. If the improved outcomes of patients managed using bedaquiline-containing shorter treatment regimens in other countries can be attained in Nigeria, Model F would be the recommended model for the scale up of RR/MDR-TB care in Nigeria.

scholarly journals Second Line Drugs Resistant Mycobacterium Tuberculosis in Multi-Drug Resistant Tuberculosis Patients

2018 ◽  
Vol 22 (2) ◽  
pp. 168-174
Author(s):  
Pranita Tuladhar ◽  
Dhruba Kumar Khadka ◽  
Megha Raj Banjara ◽  
Reshma Tuladhar
Keyword(s):  
Drug Susceptibility ◽  
Resistance Pattern ◽  
Drug Resistant ◽  
Second Line ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Culture Positive ◽  
Line Drug

With an increase in Multi-drug resistant tuberculosis (MDR-TB), there is a need of second line drug susceptibility test that helps in early diagnosis and minimize the risk of other powerful drug resistant Mycobacterium tuberculosis. The aim of this study was to determine second line drugs (ofloxacin, kanamycin, capreomycin) resistance pattern in MDR-TB isolates and to determine the prevalence of pre-Extensively drug resistant tuberculosis (pre-XDR-TB) and XDR-TB in MDR-TB patients. The study was conducted from February to September 2015 at National Tuberculosis Centre, Thimi, Bhaktapur. MDR-TB (resistant to isoniazid and rifampicin) patients’ sputum samples were processed by Modified Petroff’s method. Out of 92 samples, 57 were found culture positive. Following the species identification of culture positive MDR-TB isolates, second line drug susceptibility test was performed by conventional proportion method. Of 57 MDR-TB isolates, 22 (38.59%) showed resistance to ofloxacin (Ofx), 9 (15.79%) to capreomycin (Cm) and 9 (15.79%) to kanamycin (Km). One XDR-TB (1.8%) resistant to all drugs was detected. Of the remaining, 21(36.8%) were resistant to ofloxacin only and 8(15.4%) were resistant to two drugs i.e.29 (50.9%) were pre-XDR-TB. The prevalence of pre-XDR-TB and XDR-TB was found to be 50.88% and 1.75% respectively. The resistance pattern of second line anti-tuberculosis drugs showed higher ofloxacin resistance in MDR-TB patients. In a nutshell, MDR-TB cases need urgent and timely susceptibility report for second line anti-tuberculosis drugs to help the clinicians start proper drug combinations to treat MDR-TB patients. Journal of Institute of Science and Technology Volume 22, Issue 2, January 2018, page: 168-174

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