Abstract

A STUDY ON ADVERSE DRUG REACTIONS OF ANTITUBERCULAR DRUGS IN TREATMENT OF TUBERCULOSIS: A NARRATIVE REVIEW

SK. Arshiya Kowser*, B. Bhavani, K. Evangil, K. Amulya, M. Venkata Rao and

Abstract

Drug-sensitive tuberculosis (DS-TB) requires treatment with 1st-line drugs whereas drug-resistant TB (DR-TB) are treated with combination of 2nd-line drugs and fewer 1st-line drugs. Adverse drug reactions (ADRs) to these drugs are quite evident as they are being used for longer duration. The overall prevalence of ADRs with 1st-line drugs and 2nd-line drugs are estimated to vary from 8.0 - 85 and 69 - 96%, respectively. Most ADRs are observed in the intensive phase as compared to continuation phase. Major concerns exist regarding treatment of DR-TB patients, especially with 2nd- line drugs having lower efficacy more toxicity and high cost as compared to 1st-line drugs. A variety of ADRs may be produced by anti-TB drugs ranging from mild or minor to severe or major like gastrointestinal toxicity (nausea/vomiting, diarrhoea and hepatotoxicity), ototoxicity, neurotoxicity (peripheral neuropathy and seizures), nephrotoxicity, cutaneous toxicity and cardiotoxicity. Most of ADRs are minor and can be managed without discontinuation of treatment. Few ADRs’ can be major causing life-threatening experience leading to either modification or discontinuation of regimen and even mortality. A careful monitoring of ADRs during the treatment with anti-TB drugs and early recognition and appropriate management of these ADRs might improve adherence leading to favorable outcome.

Keywords: Tuberculosis (TB) Adverse drug reactions (ADRs), Drug-sensitive TB (DS-TB), Drug- resistant TB (DR-TB), Anti-TB drugs; 1st-line drugs, 2nd-line drugs.