A study of adverse drug reactions in patients receiving treatment for multidrug-resistant tuberculosis in a tertiary care center

ABSTRACT

Background: The emergence of multidrug-resistant tuberculosis (MDR-TB) (defined as resistance to at least isoniazid and rifampin) poses a threat to global TB control. Second line drugs are frequently associated with very high rates of unacceptable adverse drug reactions (ADRs), needing frequent interruption and change of regimen. Different studies have stated varying incidence of these adverse effects leading to discontinuation of ATT. Aims and Objectives: This study intends to find out the occurrence of side effects of anti-TB drugs in patients receiving MDR treatment. Material and Methods: The present prospective cross-sectional observational study was carried out at Drug-Resistant TB Center at Govt. Medical College Kota for a period of July 2018 to June 2019. Patients with adverse events after the introduction of treatment of MDR-TB were included in the study. We monitored the patients with adverse events after starting treatment till the patients were admitted and later followed up by recalling the patients at monthly intervals. Results: Out of total 148 patients majority patients (64.81%) were in the young age group (20–39 years) with male female ratio 21. Out of the 148 patients, 112 patients developed at least one or more types of ADR and a total of 15 types of ADR. Gastrointestinal upset was the most common ADR reported (62.16%) followed by joint pain (41.89%) and headache (36.48%). About 60.74% of all ADRs were managed by symptomatic treatment. 32 (21.62%) patients required change of regimen.Twelve patients (8%) discontinued treatment due to adverse reactions. Conclusion: Treatment of MDR-TB with second-line antitubercular drugs is associated with high rate of adverse effects experienced in more than half of patient in this study. Ototoxicity and neuropsychiatric symptoms are major adverse effects lead to important drug withdrawl from the regimen. The health care professionals should be alert during the intensive phase of the treatment, identify symptoms at the earliest and hence help in minimizing morbidity.