Impact of adverse drug reaction of first line anti - tuberculous drugs on treatment outcome of tuberculosis under revised national tuberculosis control programme
DOI:
https://doi.org/10.18203/2349-3933.ijam20171512Keywords:
Adverse drug reactions, Ethambutol, Isoniazid, Pyrazinamide, Rifampicin, TuberculosisAbstract
Background: Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis, is the major health care burden responsible for morbidity and mortality. The objective was to study the profile of adverse drug reactions (ADRs) and its outcome.
Methods: It was a prospective observational study conducted in one of the RNTCP centre of Ahmedabad district. All TB patients visiting and taking short course of directly observed treatment (DOTS) were enrolled and monitored for ADRs. All the ADRs spontaneously reported or identified by the researcher were recorded and analyzed.
Results: Total 974 patients screened during the study period 72 (7.79%) developed ADRs. Significantly higher occurrence of ADRs were in age group of 31- 40 years (p<0.01). Out of these 72 patients, 49 (68%) were having pulmonary TB. No statistically significant association was found between gender of patient, site of TB and occurrence of ADRs (p>0.05). Occurrence of ADRs was significantly more (p<0.05) in patients of category I TB (31, 43%). Out of the 49 (68%) pulmonary tuberculosis patients who developed ADR, 32 patients (44%) were sputum positive showing significant association (p<0.05). Gastro-intestinal side effects were most common ADRs followed by giddiness and headache. Nine patients required complete stoppage of offending agent, while 2 patients require treatment interruption and most of the patients (61) were managed with supportive medication without removing anti tubercular drug from their treatment regimen. Out of these 72 patients, majority (56) declared cured at the end of treatment.
Conclusions: ADRs are major factor limiting completion of drug therapy under RNTCP and occurrence of drug resistance which requires attention of all health care professionals.
References
Nehaul LK. Tuberculosis. In: Walker R, Edwards C, editors. Clinical pharmacy and Therapeutics. 3rd edition. Edinburgh: Churchill Livingston. 2003:583-95.
Park K. Park’s textbook of preventive and social medicine. 18th ed. Jabalpur: M/s Banarsidas Bhanot. 2005:146-61.
Sharma SK, Mohan A. Tuberculosis. 2nd ed. New Delhi: Jaypee Brothers Medical Publishers; 2009:14-29.
Centers for Disease Control and Prevention. American Thoracic Society, CDC, and Infectious Diseases Society of America. Treatment of tuberculosis. MMWR. 2003;52(RR-11):1-77.
Myers JP. New recommendations for the treatment of tuberculosis. CurrOpin Infect Dis. 2005;18:133-40.
Schaberg T, Rebhan K, Lode H. Risk factors for side-effects of isoniazid, rifampin and pyrazinamide in patients hospitalized for pulmonary tuberculosis. EurRespir J. 1996;9:2026-30.
Dossing M, Wilcke JT, Askgaard DS, Nybo B. Liver injury during antituberculosis treatment: an 11-year study. Tuberc Lung Dis. 1996;77:335-40.
Dossing M, Wilcke JT, Askgaard DS, Nybo B. Liver injury during antituberculosis treatment: an 11-year study. Tuberc Lung Dis. 1996;77:335-40.
Yee D, Valiquette C, Pelletier M, Parisien I, Rocher I, Menzies D. Incidence of serious side effects from first-line antituberculosis drugs among patients treated for active tuberculosis. Am J RespirCrit Care Med. 2003;167:1472–7.
Ormerod LP, Horsfield N. Frequency and type of reactions to antituberculosis drugs: observations in routine treatment. Tuber Lung Dis. 1996;77:37-42.
Kurniawati F, Sulaiman SAS, Gillani SW. Adverse Drug Reactions of Primary Anti-tuberculosis DrugsAmong Tuberculosis Patients Treated in Chest Clinic. International J of Pharmacy and Life Sciences. 2012;3:1331-8.
Public Health service, U.S. Department of Health,Education and welfare. Isoniazid associated Hepatits. Summary of the report of the Tuberculosis Advisory Committee and special consultants to the Director, Centre for diseases control. Morbidity and Mortality. 1974;11:97-8.
Tak DK, Acharya LD, Gowrinath K, Rao Padma GM, Subish P. Safety Evaluation Of Antitubercular Therapy Under Revised National Tuberculosis Control Programme In India. J Clin Diag Rese. 2009;3:1395-401.
Yee D, Valiguette C, Pelletier M, Parisien I, Rocher I, Menzeis D. Incidence of seri-ous side effects from First-line antitubercu-losis drugs among patients treated for Ac-tive Tuberculosis. Am J RespCrit Care Med. 2003;167:1472-7.
Aronson JK. Meyler’s Side Effects of Drugs, The Encyclopedia of Adverse Drug Reactions and Interactions. 15th ed. Elsevier. 2006;1:321-6.
Gholami K, Kamali E, Hajiabdolbagh Mi, Shalviri G. Evaluation of antituberculosis induced adverse reactions in hospitalized patients. Pharmacy Practice. 2006;4:134-8.
Bhatia ML, Jain P, Ahmad M, Moghe VV, Khan ZY. Comparison of Outcomes of Two Antitubercular Regimens in Pulmo-nary Tuberculosis at Tertiary Care Hospital, Medical Science. 2013;3:275-7.
Petri WA. Chemotherapy of tuberculosis, mycobacterium avium complex disease and leprosy. In: Bruton LL, Lazo JS, Parker KL, editors. Goodman & Gilman’s the pharmacological basis of therapeutics. 11th ed. New York: McGraw-Hill. 2006:1203-24.