Objectives This study was conducted to assess adverse drug reactions and their management in MDR-TB patients. Indonesia is the fifth highest country with multidrug-resistant tuberculosis (MDR-TB) high burden around the world. The number of MDR-TB patients in Indonesia is increasing every year, but the data regarding ADRs are still limited. Therefore, more data on their characteristics and their management is very valuable for clinicians and pharmacists. Methods The study is a descriptive study, using retrospective data of MDR-TB patients who completed therapy from January 1st, 2015 to December 31st, 2015 at the Tuberculosis Outpatient unit at the Dr. Soetomo Teaching Hospital Indonesia. Each adverse effect was judged with standards of the clinic and was documented in patients’ medical records. Results There were 40 patients included in this study. During therapy, 70% of patients developed at least one adverse drug reaction. The five most prevalent adverse effects found in this study were hyperuricemia (52.5%) followed by gastrointestinal (GI) disturbances (40%), ototoxicity (37.5%), hypokalemia (27.5%), and athralgia (12.5%). Managements that were undertaken to overcome the adverse drug reactions were adding symptomatic drugs and/or modifying the treatment regimen. Conclusions Because of the small samples we cannot attain a general conclusion. However, the result of this study is very imperative as this data gives us insight regarding adverse effects in MDR-TB patients in Indonesia.

Farida Anwari 1), Melawati Olevianingrum 2), Umi Fatmawati 3) (Times New Roman, 11pt, bold)STIKES RS. Anwar Medika Sidoarjo, Jl. Bypass Krian KM 33 Balongbendo, Sidoarjofaridamph@gmail.com Hp. 08123248102 ABSTRACT           Polluted air and contaminated seeds can cause various lung diseases, one of which is indicated by cough changes. Coughing into body shape, occurs as a response from the body to irritation in the throat due to mucus, dust, smoke and air outside the body. Nebulizer is an alternative tool to relieve the cough response to the presence of mucus which is an inflammatory reaction due to infection in the respiratory tract. Mint oil in the form of extracts has a variety of esters, especially menthyl acetate and monoterpenes which produce a distinctive aroma that is beneficial for breathing. The aim of the study was to examine the effect of adding mint oil as a result of distillation on the liquid with the nebulizer in cough handling.       This study was a pre-experimental study with nonrandomized design pre test and post test with control group design which was used to determine the effect of the addition of mint oil as a result of distillation on the liquid with nebulizer to reduce the coughing status of the patient which included (cough frequency, onset of inflammation, wheezing, and ease of expectoration of phlegm).      The results showed that the cough frequency status is known to have decreased from 44.4% of patients to 23.5% of patients. Similarly, the status of inflammation decreased from 41.7% to 21.7%; wheezing status which was originally 58.3% decreased to 39.1%; easy  expectoration status also shows that mint oil can reduce the level of difficulty of phlegm to go out to 13% from 36.1%.

Objectives Indonesia is one of the top 20 countries with the highest prevalence of drug resistant tuberculosis (DR-TB) worldwide with a percentage of new cases of 2.4% and retreatment of 13%. Bedaquiline (BDQ) is one of the drugs that used in the individual long regimen treating DR-TB. BDQ is also combined with levofloxacin (LFX) and/or clofazimine (CFZ) that can cause QTc interval prolongation. The aim was to study the differences in the use of BDQ regimens to the lengthening of the QTc interval and to study risk factors (diabetes, hypokalemia, sex, BMI, and age) in BDQ regimen. Methods This study was an observational retrospective study with a total sampling method, which was conducted at Dr. Soetomo General Hospital Surabaya. Samples from this study were patients diagnosed with DR-TB at Dr. Soetomo General Hospital Surabaya in the period of January 2015–December 2019 who used BDQ regimen and met the inclusion criteria. The ECG data were analyzed from the mean of each group (BDQ regimen and risk factors), also analyzed using statistical analysis. Results Data obtained from total sample in this study were 73 patients. The most widely used different regimens in this study were the combination of BDQ + LFX by 36 patients (49.3%), BDQ + LFX + CFZ by 16 patients (21.9%), BDQ by 11 patients (15.1%) and BDQ + CFZ 10 patients (13.7%). Out of 73 patients, 52 patients (71.2%) experienced lengthening of the QT interval and grade 1 of QTc interval prolongation occurred in most patients and also the onset was mostly one month after using BDQ regimen. The side effects of QTc interval prolongation from groups of combination and risk factors were no difference in each month (p>0.05). Conclusions This study can be concluded that there were no differences in the QTc prolongation between the groups of BDQ regimen (BDQ, BDQ + LFX, BDQ + CFZ and BDQ + LFX + CFZ) and the groups of risk factors.

Objectives This study aimed to estimate the prevalence and analyze the risk factors for linezolid-induced hematological side effects in multidrug-resistant tuberculosis (MDR-TB) patients. Methods Data were collected from medical records of MDR-TB patients who received linezolid between January 2018 and May 2020. Statistical significance analysis and multivariate analysis were performed with SPSS version 24 software. Results Hematological side effects were identified in 27 out of 93 patients (29.0%). The most prevalent effect was anemia (29.0%), while the less prevalent effects were thrombocytopenia (3.2%) and leukopenia (2.2%). These side effects were reported after 2 weeks of linezolid treatment. The drug dose was more than 11 mg/kgBW/day or patient weighing less than 54 kg was identified as an independent risk factor for anemia in multivariate analysis. Conclusions Anemia was the most prevalent of linezolid-induced hematological side effects in MDR-TB patients. Therefore, hemoglobin monitoring might be recommended in patients weighing less than 54 kg and after receiving linezolid therapy for at least 2 weeks.

Background: The Multi Drug Resistance Tuberculosis (MDR-TB) prevalence rate is by 6900 in which there are 1.9% of new cases and 12 % of cases fail. Indonesia ranks eighth out of 27 countries in the world. This study is aimed to investigate the characteristics of the new MDR TB patient demographic data, treatment, and side effects. Method: This research was analyzed retrospective data of the Medical Record (MR). Data were analyzed qualitatively. Results: The number of new patients are 82 people consisting of 41 men and 41 women. About 35 patients came from Surabaya and 47 were from outside Surabaya. Among those, 28 patients are 51–60 years old. Patients in the intensive phase (0–8 month) were 47 patient and 35 patients were in the continue phase 9–24 month. The main cause is the highest MDR-TB relapse 33 patients. Cycloserin and ethionamide prescribed to all of the subject followed by levofloxacin which is prescribed to 68 patients. The other medication were kanamycin, capreomycon, moxifloxacin and Para Amino Salicylat (PAS) which administered to 27,14,7 patient consecutively. Nausea is the one of the Adverse Drug reaction (ADR) that is preverly emerged. There were 30 patients complary this ADR and treatment which Omeprazole and Ranitidin. Conclusion: Characteristics of patients greatly differed between patients categories. In Soetomo hospital effort should be made to improve management case, drug and prevent or eliminate adverse drug reaction.