- Visibility 95 Views
- Downloads 62 Downloads
- Permissions
- DOI 10.18231/pjms.v.15.i.2.289-291
-
CrossMark
- Citation
Study of adverse drug reactions (ADR’S) requiring change in anti-tubercular regimen in multi-drug resistant tuberculosis (MDR-TB) patients in a tertiary healthcare centre
- Author Details:
-
Ashwin Unni *
-
Priti Meshram
-
Vishwanath Pujari
-
Rohit Hegde
Introduction: Multi Drug Resistant Tuberculosis is fast emerging as a global health problem, especially in developing countries like India with a high Tuberculosis burden and poses a major hurdle in the fight against eliminating Tuberculosis. Considering the long duration of treatment in patients of Multi Drug Resistant Tuberculosis (MDR-TB), it is important to keep an eye on adverse drug reactions (ADR) in these patients during follow up. Severe adverse drug reactions warrant discontinuation of drugs in many patients and can also become a significant factor for poor compliance to second line drugs in Multi Drug Resistant Tuberculosis (MDR-TB) patients.
Materials and Methods: The study was an observational based study conducted in the Department of Pulmonary Medicine of a tertiary healthcare centre in Mumbai between over a period of 1 year. A Total of 60 patients out of 172 patients (34.8%) of MDR-TB having ADR and who required a change in their regimen were identified for the study.
Results: A total of 60 patients of MDR-TB patients were identified who had a change of anti-tubercular regimen due to adverse drug reaction, which were done as per Line Probe Assay (LPA) and Drug Sensitivity Testing (DST) reports of which 38 were females and 22 were males. The most commonly withheld drug was Linezolid in 37 (61.67 %) patients, followed by Cycloserine in 8 patients, Delaminid in 5 patients, Bedaquiline in 4 patients.
Conclusion: Severe ADR’s are one of the commonest requiring change in anti-tubercular regimen, leading to poor adherence and suboptimal treatment, especially when drugs like Bedaquilline, Delaminid, Moxifloxacin and Linezolid are to be discontinued.
References
- World Health Organization. Meeting report of the WHO expert consultation on the definition of extensively drug-resistant tuberculosis [Internet]. 2020. (Accessed 16 March 2021). https://www.who.int/publications/i/item/meeting-report-of-the- who-expert-consultation-on-the-definitionof-extensively-drug- resistant-tuberculosis.
- Collaborative Group for the Meta-Analysis of Individual Patient Data in MDR-TB treatment–2017; Ahmad N, Ahuja SD, Akkerman OW, Alffenaar JC, Anderson LF, Baghaei P, Bang D, Barry PM, et al ;Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta- analysis. Lancet. 2018;392(10150):821–34.
- Dela AI, Tank ND, Singh AP, Piparva KG. Adverse drug reactions and treatment outcome analysis of DOTS-plus therapy of MDR-TB patients at district tuberculosis centre: A four year retrospective study. Lung India. 2017;34(6):522–6.
- Prasad R, Singh A, Gupta N. Adverse drug reactions in tuberculosis and management. Indian J Tuberc. 2019;66(4):520-32.
- Yang L, Feng S, Wenhong Z. Bedaquiline and delamanid in the treatment of multidrug-resistant tuberculosis: Promising but challenging. Drug Dev Res. 2019;80(1):98-105.
- Martín-García M, Esteban J. Evaluating bedaquiline as a treatment option for multidrug-resistant tuberculosis. Expert Opin Pharmacother. 2021;22(5):535-41.
- Pratama NYI, Zulkarnain BS, Soedarsono, Fatmawati U. Hematological side effect analysis of linezolid in MDR-TB patients with individual therapy. J Basic Clin Physiol Pharmacol. 2021;32(4):777–81.
- von der Lippe B, Sandven P, Brubakk O. Efficacy and safety of linezolid in multidrug resistant tuberculosis (MDR-TB)--a report of ten cases. J Infect. 2006;52(2):92–6.
- Zhang P, Li W, Liu M, Zhan S, Zhang H, Deng G, et al. Linezolid- Associated Neuropathy in Patients with MDR/XDR Tuberculosis in Shenzhen, China. Infect Drug Resist. 2022;15:2617–24.
- Mandovra NP, Lele TT, Vaidya PJ, Chavhan VB, Leuppi- Taegtmeyer AB, Leuppi JD, et al. High Incidence of New-Onset Joint Pain in Patients on Fluoroquinolones as Antituberculous Treatment. Respiration. 2020;99(2):125–31.
- Guidelines for programmatic management of Drug Resistant Tuberculosis in India. Ministry of Health and Family Welfare(MoHFW), Government of India . 2021:43-145. https://tbcindia.mohfw.gov.in/wp- content/uploads/2023/05/8368587497Guidelines-for-PMDT-in- India-1.pdf
- Rupani MP, Dave JD, Parmar VB, Singh MP, Parikh KD. Adverse drug reactions and risk factors for discontinuation of multidrug- resistant tuberculosis regimens in Gujarat, western India. Natl Med J India. 2020;33(1):10–4.
- Bhushan B, Chander R, Kajal NC, Ranga V, Gupta A, Bharti H. Profile of adverse drug reactions in drug resistant tuberculosis from Punjab. Indian J Tuberc. 2014;61(4):318–24.
- Sharma B, Handa R, Nagpal K, Prakash S, Gupta PK, Agrawal R. Cycloserine-induced psychosis in a young female with drug- resistant tuberculosis. Gen Hosp Psychiatry. 2014;36(4):451.e3–4.
- Asfaw MT, Holtzman DL, Kwan GF, Oyewusi LT, Mitnick CD, Seung KJ. Incidence of high grade QTCF prolongation and its management among patients undergoing treatment for Drug Resistant Tuberculosis (DR-TB): Case series. Afr J Infect Dis. 2021;15(2 Suppl):38–41.
- Wrohan I, Redwood L, Ho J, Velen K, Fox GJ. Ototoxicity among multidrug-resistant TB patients: a systematic review and meta- analysis. Int J Tuberc Lung Dis. 2021;25(1):23–30.
How to Cite This Article
Vancouver
Unni A, Meshram P, Pujari V, Hegde R. Study of adverse drug reactions (ADR’S) requiring change in anti-tubercular regimen in multi-drug resistant tuberculosis (MDR-TB) patients in a tertiary healthcare centre [Internet]. Panacea J Med Sci. 2025 [cited 2025 Oct 27];15(2):289-291. Available from: https://doi.org/10.18231/pjms.v.15.i.2.289-291
APA
Unni, A., Meshram, P., Pujari, V., Hegde, R. (2025). Study of adverse drug reactions (ADR’S) requiring change in anti-tubercular regimen in multi-drug resistant tuberculosis (MDR-TB) patients in a tertiary healthcare centre. Panacea J Med Sci, 15(2), 289-291. https://doi.org/10.18231/pjms.v.15.i.2.289-291
MLA
Unni, Ashwin, Meshram, Priti, Pujari, Vishwanath, Hegde, Rohit. "Study of adverse drug reactions (ADR’S) requiring change in anti-tubercular regimen in multi-drug resistant tuberculosis (MDR-TB) patients in a tertiary healthcare centre." Panacea J Med Sci, vol. 15, no. 2, 2025, pp. 289-291. https://doi.org/10.18231/pjms.v.15.i.2.289-291
Chicago
Unni, A., Meshram, P., Pujari, V., Hegde, R.. "Study of adverse drug reactions (ADR’S) requiring change in anti-tubercular regimen in multi-drug resistant tuberculosis (MDR-TB) patients in a tertiary healthcare centre." Panacea J Med Sci 15, no. 2 (2025): 289-291. https://doi.org/10.18231/pjms.v.15.i.2.289-291