Hepatotoxic reactions during treatment of newly diagnosed patients with pulmonary multiple drug resistant tuberculosis

Autor: R. Yu. Аbdullаev, O. G. Komissаrovа, E. S. Chumаkovа, V. S. Odinets, A. E. Ergeshov
Jazyk: ruština
Rok vydání: 2019
Předmět:
Zdroj: Туберкулез и болезни лёгких, Vol 97, Iss 7, Pp 21-27 (2019)
Druh dokumentu: article
ISSN: 2075-1230
2542-1506
DOI: 10.21292/2075-1230-2019-97-7-21-27
Popis: 216 new pulmonary tuberculosis patients suffering from multiple drug resistance (MDR) were examined. The patients were divided into 2 groups. The first group consisted of 164 patients in whom when admitted to hospital, GeneXpert MTB/RIF was used to test the resistance of Mycobacterium tuberculosis (MTB) to rifampicin. Initially, patients in this group were treated with chemotherapy regimen 4 (pyrazinamide, kanamycin/amikacin/capreomycin, fluoroquinolones, cycloserine/terizidone, prothionamide, PAS). Group 2 included 97 patients. They all were treated with chemotherapy regimen 1 (isoniazid, rifampicin, pyrazinamide, ethambutol/streptomycin) before MDR was confirmed in them by sputum culture on solid media (in 2-3 months of treatment) after that treatment regimen was amended with re-registration for chemotherapy regimen 4. It was found out that hepatotoxic reactions in patients without initial abnormal liver function when prescribing chemotherapy regimen 4 occurred in 31.3% of cases and when initially using regimen 1 followed by switching to regimen 4 – in 87.8% of cases ( p < 0.001). In the course of treatment, the signs of liver damage in patients who initially received regimen 4 were more frequent in the first 2 months of treatment, whereas in patients treated initially with regimen 1 with subsequent switching to regimen 4 – during the first 4 months. In the overwhelming majority of cases, hepatotoxic reactions were mild in patients who initially received regimen 4 as well as in patients initially treated with regimen 1 followed by switching to regimen 4. However, severe hepatotoxic reactions were more often observed in patients from Group 2.
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