Impact of the change in the antitubercular regimen from three to four drugs on cure and frequency of adverse reactions in tuberculosis patients from Brazil: A retrospective cohort study

Autor: Ninfa Marlen Chaves Torres, María B. Arriaga, Eduardo Martins Netto, Simone Castro Couto Caldas, Nelia C. N. Araujo, Bruno B. Andrade
Rok vydání: 2019
Předmět:
Male
Bacterial Diseases
Extensively Drug-Resistant Tuberculosis
Antitubercular Agents
Geographical locations
0302 clinical medicine
Medicine and Health Sciences
030212 general & internal medicine
Multidisciplinary
Pharmaceutics
Incidence
Incidence (epidemiology)
Drugs
Middle Aged
Treatment Outcome
Infectious Diseases
Tuberculosis Diagnosis and Management
Medicine
Female
Brazil
Research Article
medicine.drug
Adult
medicine.medical_specialty
Tuberculosis
Drug-Related Side Effects and Adverse Reactions
Science
Fixed-dose combination
Microbiology
Young Adult
03 medical and health sciences
Adverse Reactions
Drug Therapy
Diagnostic Medicine
Microbial Control
Internal medicine
Isoniazid
medicine
Humans
Ethambutol
Retrospective Studies
Pharmacology
business.industry
Biology and Life Sciences
Extensively drug-resistant tuberculosis
Retrospective cohort study
Odds ratio
South America
Tropical Diseases
medicine.disease
Regimen
030228 respiratory system
Antibiotic Resistance
Antimicrobial Resistance
People and places
business
Zdroj: PLoS ONE, Vol 14, Iss 12, p e0227101 (2019)
PLoS ONE
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0227101
Popis: Background The Ministry of Health in Brazil included ethambutol in the intensive phase of sensible tuberculosis (TB) treatment in March 2010, due to the increasing drug resistance, and implemented the fixed dose combination in the TB treatment guidelines. Methods A retrospective cohort study was performed to determine the impact of change from three to four drugs schemes on the TB cure and frequency of adverse drug reactions (ADRs) in TB patients. To answer this question, we used data from 730 randomly selected patients who received anti-TB treatment between January 2007 and December 2014 in a reference center from Salvador, Brazil. Findings TB patients who received the RHEZ regimen (n = 365) developed ADRs more frequently than those treated with the RHZ (n = 365) (86 [23.6%] vs. 55 [15.1%]; p = 0.01). This difference in ADR incidence was even higher in patients above 30 years-old (64 [74.4%] vs. 36 [65.5%]; p = 0.01). The overall number of ADR episodes was greater in patients from the RHEZ group than in the group that received RHZ (170 [61.4%] vs. 107 [38.6%]; p = 0.03). Multivariable logistic regression analysis adjusted for age, alcohol use and diabetes demonstrated that patients receiving the RHEZ regimen had increased odds of developing ADRs than those undertaking the RHZ scheme (odds ratio [OR]: 1.61, 95% confidence interval [CI]: 1.10-2.35; p = 0.015). The overall cure rate was similar between the distinct treatment groups. Conclusion The patients treated with the four-drug regimen exhibited increased risk of ADRs compared to those who received the three-drug regimen, and especially in patients older than 30 years of age.
Databáze: OpenAIRE
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