Between Curing and Torturing: Burden of Adverse Reaction in Drug-Resistant Tuberculosis Therapy

Ausi, Yudisia; Santoso, Prayudi; Sunjaya, Deni Kurniadi; Barliana, Melisa Intan

doi:10.2147/ppa.s333111

Cited by 20 publications

(14 citation statements)

References 86 publications

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“…Although patients taking the regimen used in the study of Conradie et al (15) should be monitored carefully, these toxic effects were manageable. ADEs are peripheral neuropathy, optic neuritis (13%), visual manifestations (24) and other gastrointestinal disturbances (30,31).…”

Section: Clostridioides Difficile-associated Diarrhoea Is An Importantmentioning

confidence: 99%

“…The common manifestations of arthropathy and cartilage erosion were joint pain, stiffness and swelling of weightbearing joints, particularly knees (23), and QT prolongation (24). More recent concerns regarding musculoskeletal adverse effects of fluoroquinolones involve the possibility of tendinitis and tendon rupture (more often Achilles tendon) (23).…”

Section: Adverse Effectsmentioning

confidence: 99%

“…The most common ADEs associated with these drugs are intense gastrointestinal effects (anorexia, nausea, vomiting, metallic taste in the mouth and gastric irritation) (37,42), hepatotoxicity (31) and a variety of neurological symptoms (peripheral neuritis, peripheral neuropathy, optic neuritis, diplopia, irritability, anxiety, depression, hallucinations, convulsions and psychosis) (22,37,43). Postural hypotension, drowsiness, asthenia, convulsions, allergic skin rashes, purpura, hypothyroidism, gynaecomastia (24), impotence, menorrhagia and alopecia can occur in patients treated with Eto (42)(43)(44). The neurological effects can be minimised by administering pyridoxine (43).…”

Section: Adverse Effectsmentioning

confidence: 99%

“…Gastrointestinal symptoms and hepatotoxicity are common ADEs, followed by arrhythmia and rash (31), arthralgia and dermatological disorders (24). Thrombocytopenia and sideroblastic anaemia are very rare ADEs (26).…”

Section: Adverse Effectsmentioning

confidence: 99%

“…Elderly patients, those under long-term treatment and those with a history of kidney disease have a higher occurrence of renal toxicity (30,41). The most significant manifestations of nephrotoxicity include decreased creatinine clearance, electrolyte imbalance (24) and increased serum levels of urea and creatinine, proteinuria and oliguria (37,40,41). Aminoglycosides can cause respiratory failure due to rapid intravenous injection of the drug in patients who are under treatment with anaesthetics or neuromuscular blocking of cases with extended TB (multiple lesions and fibrothorax) as well as in the number of cases of MDR-TB and XDR-TB.…”

Section: Adverse Effectsmentioning

confidence: 99%

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Adverse effects induced by second-line antituberculosis drugs: an update based on last WHO treatment recommendations for drug-resistant tuberculosis

et al. 2021

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Introduction: Tuberculosis (TB), a common condition worldwide, is still among the main infectious diseases with high mortality rates, both in adults and infants. Drug-resistant tuberculosis (DR-TB) drugs, revised by the World Health Organization (WHO) in 2018, are a prolonged and complex therapy associated with many adverse drug effects (ADEs). Aim: To systematically review the ADEs of second-line anti-TB drugs reported in multicentric studies published after the latest WHO guidelines, compared with those from clinical trials published before 2018. Material and methods: A PubMed search, using keywords (TB OR DR-TB) AND (adverse effects) AND “second-line anti-TB drugs”, resulted in 56 studies. Only two studies, published after the last update of WHO guidelines in 2018, reported ADEs. Results: A total of 223 participants were included in the two selected studies. The use of multidrug regimens has been associated with an increased incidence of ADEs: 42 ADEs were recorded in 30 patients (26.3%) in the first study, while all patients had at least one ADE that occurred or worsened during treatment; and 19 (17%) had severe ADEs in the second study. However, both studies had a good favourable outcome rate (90% and 79.8%, respectively). Gastrointestinal disturbances, hepatotoxicity, headache and dizziness are the most common ADEs induced by a majority of second-line DR-TB treatments. A special attention should be given in the case of association of drugs determining QT interval (QT) prolongation on electrocardiogram, or psychiatric disorders. Conclusions: Proper strategies about ADE management have to be planned for timely detection of the possible ADEs that can be induced by second-line anti-TB therapy.

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Section: Clostridioides Difficile-associated Diarrhoea Is An Importantmentioning

confidence: 99%