ADVERSE DRUG REACTIONS WITH FIXED-DOSE COMBINATIONS IN TUBERCULOSIS PATIENTS

Main Article Content

Mohit Bhardwaj
Ayush Pandey
Dps Sudan
Suresh Koolwal

Keywords

Tuberculosis, Fixed Drug Combinations, Adverse Reactions

Abstract

Background:Government of India's National Tuberculosis Elimination Program (NTEP) has startedimplementing daily fixed dose combination (FDC), anti-TB treatment regimen for drug sensitive TBpatients. This study was designed to assess the frequency, types and impactof adverse drug reactions
(ADR) to category 1 anti-tubercular therapy using fixed drug combinations (FDC).
Methodology:This was a hospital-based observational study in the population of rural Haryana forone year from 30thSeptember 2020 to 30thSeptember 2021 in the SGT Medical College in theDepartment of Pulmonary Medicine.
Result:We encountered 384 patients who were started on ATT for the treatment of tuberculosis.Among them, 26.04% suffered from mild to life-threatening adverse drug reactions (ADR) due to theDOTS regimen. 74% of the ADR was seen in patients with pulmonary TB andthe rest withextrapulmonary tuberculosis. Among the total population treated, 18.49% suffered from ADR ofvarying severity while being treated for pulmonary TB. Similarly, 7.55% developed ADR while beingtreated for extrapulmonary TB. The most common ADR encountered was hepatitis in 39% of theaffected group.
Conclusion:Adverse reactions were commoner among the elderly, and were associated withprolongation and modification of anti-tuberculosis therapy but overall treatment outcomes were not
adversely affected.

Abstract 191 | PDF Downloads 107

References

1.Global tuberculosis report 2019. Geneva: World Health Organization; 2019. Licence: CC BY-
NC-SA 3.0 IGO.(Last Accessed on January 2020)
2.Wu Z, Chen J, Xia Z, Pan Q, Yuan Z, Zhang W, Shen X. Impact of the COVID-19 pandemic on
the detection of TB in Shanghai, China. Int J Tuberc Lung Dis. 2020 Oct 1; 24(10):1122-4.
3.WHO, 2022a. World TB Day 2022.https://www.who.int/campaigns/world-tb-
day/2022file:///C:/Users/Prof%20Zumla/Downloads/simultaneous_testing_tb_covid%20(3).pdfaccessed 17th February, 2022
4.Balasubramanian VN, Oommen K, Samuel R. DOT or not?Direct observation of anti-
tuberculosis treatment and patient outcomes, Kerala State, India. Int J Tuber Lung Dis2000;4:409-13.
5.World Health Organisation.An expanded DOTS framework for effective tuberculosis control.
Stop TB Communicable Diseases.Geneva: WHO Press; 2002.p.1-20.
6.Dhingra VK, Rajpal S, Aggarwal N, Aggarwal JK, Shadab K, Jain SK.Adverse drug reactions
observed during DOTS. J Commun Dis2004; 36:251-9.
7.Chukanov VI, Kaminskaia GO, Livchane E. Frequency and patternof adverse reactions due to
treatment of patients with pulmonary tuberculosis with antitubercular reserve drugs. Prob TuberkBoleznLegk 2004; 10:6-10.
8.The Union Anti-tuberculosis Regimens of Chemotherapy.Recommendations from the Committee
on Treatment of the International Union against Tuberculosis and Lung Disease.Bull Int UnionTuberc Lung Dis. 1988; 63(2):60–64.
9.Ferreira AC, Silva Junior JL, Conde MB, RabahiMF. Clinical treatment outcomes of tuberculosis
treated with the basic regimen recommended by the Brazilian National Ministry of Health usingfixed-dose combination tablets in the greater metropolitan area of Goiania, Brazil.J BrasPneumol.2013; 39(1):76–83.
10.World Health Organisation. An expanded DOTS framework for effective tuberculosis control.
Stop TB Communicable Diseases.Geneva:WHO Press;2002.p.1-20.