Incidence of cycloserine induced neurotoxicity in drug resistant TB patients attending a tertiary care hospital

Singhal, Pratibha; Lunia, Prajay; Salgia, Kapil; Syed, Iram

doi:10.1183/13993003.congress-2020.1593

Cited by 3 publications

(2 citation statements)

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“…We found strong evidence that suggests that neuropathy and neurotoxicity caused by ethambutol, thioamides, and linezolid are concentration and duration dependent [42] [70]- [76]. Neurotoxicity caused by Cs, on the other hand, is only concentration-dependent but does not seem to depend on the duration of use and paradoxically, it has been related to taking higher pyridoxine doses [77].…”

Section: Discussionmentioning

confidence: 91%

The Role of Pyridoxine in the Prevention and Treatment of Neuropathy and Neurotoxicity Associated with Rifampicin-Resistant Tuberculosis Treatment Regimens: A Topic Review

Kariuki¹,

Kariuki²,

Angel³

2023

JTR

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Rifampicin-resistant tuberculosis (RR-TB) is a global public health problem caused by mycobacterium tuberculosis resistant to Rifampicin. Drug-induced peripheral neuropathy and neurotoxicity are well-known adverse effects of treatment regimens that cause significant morbidity. Pyridoxine is often added to treatment regimens for the prevention and/or treatment of these side effects. The basis and effectiveness of this practice are unclear. We conducted a systematic review to evaluate the effectiveness of pyridoxine in preventing and/or treating neuropathy and neurotoxicity associated with RR-TB treatment. We included studies with patients with RR-TB who experienced neuropathy or neurotoxicity attributed to RR-TB regimens and were given pyridoxine. Our findings showed contradicting evidence on the use of pyridoxine for preventing or treating neurotoxicity due to cycloserine in the treatment of RR-TB. Moreover, pyridoxine did not have a protective effect against neuropathy and/or neurotoxicity caused by other RR-TB regimens that do not contain isoniazid. In conclusion, we found that withdrawing or withholding medications such as linezolid, cycloserine, thioamides, fluoroquinolones, and ethambutol, implicated in causing neuropathy or neurotoxicity was more effective than using pyridoxine to stop the progression of symptoms, and in some instances, led to their reversal over time.

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Section: Discussionmentioning

confidence: 91%

The Role of Pyridoxine in the Prevention and Treatment of Neuropathy and Neurotoxicity Associated with Rifampicin-Resistant Tuberculosis Treatment Regimens: A Topic Review

Kariuki¹,

Kariuki²,

Angel³

2023

JTR

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“…16 The incidence of neurotoxicity due to Cs in DR-TB patients was recorded to be around 1-3%. 17 Cs can be bactericidal or bacteriostatic. The use of Cs often causes side effects on the CNS.…”

Section: Discussionmentioning

confidence: 99%

Cycloserine- and Fluoroquinolone-Induced Seizure in Multidrug-Resistance Tuberculosis (MDR-TB) Patient: A Case Report

Yanifitri,

Arliny,

Utami

et al. 2024

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Introduction: Multidrug-resistant tuberculosis (MDR-TB) is a type of tuberculosis (TB) that is resistant to at least two of the most effective first-line anti-TB drugs, isoniazid (H) and rifampicin (R). Cycloserine (Cs) and levofloxacin (Lfx) are second-line anti-TB drugs used in MDR-TB therapy. Even though they are considered to have high effectiveness, both drugs have the potential to cause side effects. One important side effect is neurotoxicity. Seizures have been reported as a common complication of some drugs. Case: A 39-year-old man was diagnosed with MDR-TB and was treated with individual regimens consisting of Lfx, bedaquiline (Bdq), linezolid (Lzd), clofazimine (Cfz), and Cs. After consuming anti-TB drugs for 27 days, the patient had seizures several times. The patient experienced full-body seizures and loss of consciousness during the seizures. Cs and Lfx were discontinued and replaced by other regimens. Serial electroencephalogram (EEG) showed normal results. After Cs and Lfx were discontinued, the patient never had another seizure. Conclusion: Management of MDR-TB is sometimes complicated because of severe drug side effects. Patients taking Cs and fluoroquinolones (FQs) should be advised to report any sign of seizure or changes in mental status to their healthcare provider.

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Cycloserine

2021

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Incidence of cycloserine induced neurotoxicity in drug resistant TB patients attending a tertiary care hospital

Cited by 3 publications

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The Role of Pyridoxine in the Prevention and Treatment of Neuropathy and Neurotoxicity Associated with Rifampicin-Resistant Tuberculosis Treatment Regimens: A Topic Review

The Role of Pyridoxine in the Prevention and Treatment of Neuropathy and Neurotoxicity Associated with Rifampicin-Resistant Tuberculosis Treatment Regimens: A Topic Review

Cycloserine- and Fluoroquinolone-Induced Seizure in Multidrug-Resistance Tuberculosis (MDR-TB) Patient: A Case Report

Cycloserine

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