Preliminary results of a quasi­-experimental study of treatment of rifampin­-resistant tuberculosis with an all-oral regimen containing new drugs in Zhytomyr oblast, Ukraine

The aim: To study the structure of adverse drug reactions and the effectiveness of treatment among patients with drug-resistant tuberculosis who follow the modified short-term and individualized treatment regimens. Materials and methods: The analysis of 138 inpatient medical records, outpatient health cards and electronic database of the patient register was conducted. Resistant strains of MTB were microbiologically verified in all the patients. All the patients underwent clinical-laboratory, instrumental microbiological, genetic-molecular (GeneXpert MTB / RIF) methods of examination, both for diagnosis and monitoring of the effectiveness of treatment. In order to prevent complications and control adverse reactions, all the patients were briefly screened for peripheral neuropathy, basic audiometry, the QTc interval was determined, visual acuity and color perception were checked. Results: At individualized treatment regimen of tuberculosis, adverse reactions were 3.5 times more common than in patients with modified short-term therapy, in 65 (68.4%) cases and in 8 (18.6%) cases, respectively. Accordingly, the effectiveness of treatment differed in both groups. Prevailing in long-term treatment were: treatment interruption treatment gap, treatment failure, continued treatment. In patients receiving short-term regimens, the cured rate was almost twice as common as in the second group. Conclusions: Timely detection cases of resistant tuberculosis and using linear probe analysis (LPA) - GenoType MTBDRplus for diagnosis of fluoroquinolone resistance, will allow the use of modified short-term treatment regimens for tuberculosis. Which in turn will reduce the number of side effects and improve the outcome of treatment.

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Analysis of the Effectiveness of Different Treatment Regimens for Drug-Resistant Tuberculosis in Prykarpattia. Challenges of Our Time

Makoyda

Ostrovskyy

Ostrovska

et al. 2022

Wiad Lek

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Ototoxicity of Antimycobacterial Therapy: Manifestations, Mechanisms of Management and Control

Makoyda,

Ostrovskyy,

Shevchuk-Budz

et al. 2023

Wiad Lek

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The aim: To study the nature and incidence of hearing loss related to tuberculosis (TB) or resulting from antimycobacterial therapy, and its impact on treatment outcomes in patients with multidrug-resistant TB (MDR-TB). Materials and methods: An analysis of reports on adverse reactions, medical records and electronic database of the register of TB patients was made. The pathogen was microbiologically verified in all the patients. Patients underwent clinical and laboratory, instrumental, microbiological (BACTEC), molecular genetic (Xpert® MTB/RIF® Ultra, Xpert® MTB/XDR, GenoType® MTBDRplus/sl) examinations. To prevent the development of complications and to control adverse effects, alongside with the determination of the corrected QT interval, visual acuity, and color vision, brief peripheral neuropathy screen and audiometry were performed. Results: During MDR-TB treatment with aminoglycosides, therapy was more commonly interrupted during the second episode of therapy (p=0,051), while treatment failure, longer treatment duration, and hearing impairment were almost equally observed in both groups (р=0,431, р=0,432, р=0,69). Treatment success was more commonly observed among patients receiving the first course of therapy. Some patients undergoing repeated antimycobacterial therapy were transferred to palliative care (p=0,13). The short-term treatment regimen effectively prevented ototoxicity. Conclusions: Novel antimycobacterial agents and short-term TB treatment regimens increased patient compliance with treatment and reduced the incidence of certain adverse effects due to their monitoring and prevention. Due to the transition to mainly drug therapy, adverse effects such as ototoxicity were completely eliminated. This was due to personalized treatment selection, its monitoring, and assessing the outcomes.

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Preliminary results of a quasi-experimental study of treatment of rifampin-resistant tuberculosis with an all-oral regimen containing new drugs in Zhytomyr oblast, Ukraine

Cited by 2 publications

References 8 publications

Analysis of the Effectiveness of Different Treatment Regimens for Drug-Resistant Tuberculosis in Prykarpattia. Challenges of Our Time

Analysis of the Effectiveness of Different Treatment Regimens for Drug-Resistant Tuberculosis in Prykarpattia. Challenges of Our Time

Ototoxicity of Antimycobacterial Therapy: Manifestations, Mechanisms of Management and Control

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Preliminary results of a quasi­-experimental study of treatment of rifampin­-resistant tuberculosis with an all-oral regimen containing new drugs in Zhytomyr oblast, Ukraine

Cited by 2 publications

References 8 publications

Analysis of the Effectiveness of Different Treatment Regimens for Drug-Resistant Tuberculosis in Prykarpattia. Challenges of Our Time

Analysis of the Effectiveness of Different Treatment Regimens for Drug-Resistant Tuberculosis in Prykarpattia. Challenges of Our Time

Ototoxicity of Antimycobacterial Therapy: Manifestations, Mechanisms of Management and Control

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Preliminary results of a quasi-experimental study of treatment of rifampin-resistant tuberculosis with an all-oral regimen containing new drugs in Zhytomyr oblast, Ukraine