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Adverse Effects of Multidrug-Resistant Tuberculosis Treatment With a Standardized Regimen: A Report From Iran

Baghaei, Parvaneh MD, MPH*; Tabarsi, Payam MD, MPH; Dorriz, Donna BSc; Marjani, Majid MD, MPH; Shamaei, Masoud MD; Pooramiri, Majid Valiollah MD, MPH; Mansouri, Davood MD, MPH; Farnia, Parisa PhD; Masjedi, Mohammadreza MD, MPH; Velayati, Aliakbar MD, MPH

American Journal of Therapeutics: March-April 2011 - Volume 18 - Issue 2 - p e29-e34
doi: 10.1097/MJT.0b013e3181c0806d
Original Article
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Compared with the treatment of drug-sensitive tuberculosis, the treatment of multidrug-resistant tuberculosis (MDR-TB) is more difficult. This study was conducted at the national referral center of tuberculosis in Tehran, Iran, to evaluate adverse drug reactions of treatment of MDR-TB. From 2006 to 2009, all patients admitted into Masih Daneshvari Hospital in Tehran, Iran, for MDR-TB were considered for this study. The standard treatment for MDR-TB consisted of amikacin, prothionamide, ofloxacin, and cycloserine. Ethambutol and pyrazinamide were added to treatment if mycobacterium was sensitive to them. All adverse effects observed in patients were recorded in our registry. Eighty patients were considered in the study; of this cohort, 44 were male and 36 were female. The mean age of patients was 40.64 ± 17.53 years (range, 14-81 years). All patients received standardized therapy for MDR-TB. The major adverse effects included neurologic side effects (depression, convulsions, consciousness, psychosis, suicide; 7.5%), hepatitis (5%), rash (1.3%), renal toxicity (3.8%), and auditory toxicity (14.5%). Those with neurologic side effects had less favorable outcome (P value = 0.038) and risk of death was increased among them (odds ratio, 13.8; 95% confidence interval, 2.2-86.77). Other adverse effects did not show statistical significance in our analysis. A major adverse effect such as neurologic side effects (depression, convulsions, consciousness, and psychosis) can result in an increased chance of death among patients with MDR-TB.

Mycobacteriology Research Center, National Research Institute of Tuberculosis and Lung Disease, Masih Daneshvari Hospital, Shahid Beheshti, University of Medical Sciences, Tehran, Iran.

*Address for correspondence: Masih Daneshvari Hospital, Darabad, Niyavaran Sq, Tehran, Iran. E-mail: pbaghaei@gmail.com

© 2011 Lippincott Williams & Wilkins, Inc.