Correction of Some Side Effects to Anti-Tuberculosis Therapy in Modern Conditions

Abstract

Introduction. Tuberculosis has not been eradicated in any country in the world. Chemotherapy plays a leading role in this fight. In the last two decades, the level of chemoresistant tuberculosis has increased significantly, contributing to an increase in the total number of side effects, often severe and widespread.
 The aim of the study. Improving the effectiveness of treatment and quality of life of TB patients. This is based on scientific substantiation and development of methods for drug correction of toxic side effects of anti-TB therapy.
 Materials and methods. 818 cases of complications from the use of anti-TB therapy were analyzed among patients treated at Zaporizhzhia Regional Clinical TB Dispensary between 2012 and 2016. Side effects increased over these years, due to an increased attention to pharmacovigilance.
 Results. During the treatment of patients with pulmonary TB with preserved sensitivity to anti-TB therapy, side effects occurred in 48.8% of cases and in chemoresistant forms 51.2%. Patients with resistant forms of the process which were assigned to the 4th category of treatment predominated with complications of anti-TB therapy. Their percentage was 55.1%, which was 10.2% more than patients with preserved sensitivity. The structure of side effects was dominated by hepatotoxic reactions (36.0%) which were most often (28.0%) associated with the use of pyrazinamide and later returned to normal from the use of ademethionine. In total, the use of pyrazinamide resulted in 40.4% of cases of side effects.
 Conclusions. The course of ademethionine helps to normalize clinical and laboratory parameters, regression of symptoms of toxic liver disease and improves the quality of life of patients with chemoresistant tuberculosis with toxic side effects of anti-TB therapy, which significantly reduces the length of hospital stay and increases treatment efficiency with compliance.