Frequency and risk of adverse reactions to TB therapy in children and adolescents

Abstract

Introduction. In the treatment of tuberculosis in children, the proportion of adverse events to therapy can be as high as 55 %, especially at the initial stages of treatment. Timely detection and monitoring of their development can improve the effectiveness of tuberculosis treatment.The aim of the work was to study the peculiarities of adverse reactions in children and adolescents during antituberculosis therapy for their prediction and timely detection.Materials and methods A retrospective cohort study including 243 patients aged 0 to 17 years who received treatment in two major institutions of Kemerovo Oblast – Kuzbass during 2018–2021 was conducted. Statistical processing of the material assessed risk factors for the development of adverse events in the groups with dyspeptic, toxic and allergic reactions.Results In the course of chemotherapy 88 patients (36.2 %) developed adverse reactions: dyspeptic – in 55 patients (62.5 %), allergic – in 29 (32.9 %) and toxic – in 28 patients (31.8 %). Adverse reactions developed more often in children and adolescents with concomitant diseases of the gastrointestinal tract, in the presence of complaints before treatment for tuberculosis, during treatment on IV, V chemotherapy regimens with the presence of Pto, Pas, Lfx and Cm in the scheme, as well as when taking broad spectrum antibiotics and anti-tuberculosis drugs.Discussion Despite the involvement in the process of identifying and monitoring the development of adverse reactions in TB treatment in children, the main risk factors for their development have not yet been identified. The study demonstrates the contribution to the development of adverse reactions of such factors as treatment on IV, V chemotherapy regimens, comorbid GI diseases, presence of complaints during hospitalization in a TB hospital and taking antibiotics together with antituberculosis drugs.Conclusion Undesirable phenomena were mostly observed at the start of antituberculosis therapy. Allergic, toxic and dyspeptic reactions occurred most frequently in the study group. The risk factors for their development were: IV, V chemotherapy regimens (OR = 2.5), presence of Pto (OR = 2.7), Pas (OR = 3.0), Lfx (OR = 2.3) and Cm in the CT regimen (OR = 3.8), comorbid GI diseases (OR = 3.5), complaints during hospitalization in the TB hospital (OR = 1.8) and taking antibiotics together with antituberculosis drugs (OR = 2.5).