Document Detail


Adverse reactions among patients being treated for MDR-TB in Tomsk, Russia.
MedLine Citation:
PMID:  18034952     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND SIGNIFICANCE: Treatment of multidrug-resistant tuberculosis (MDR-TB) is challenging because of the toxicity of second-line medications. Little is known about whether adverse events impact treatment outcome. METHODS: We conducted a retrospective case series of 244 MDR-TB patients enrolled in Tomsk between 10 September 2000 and 10 September 2002. Adverse reactions were determined by laboratory data and/or clinical criteria. A multiple logistic regression model was performed to determine whether the occurrence of adverse reactions was associated with poor treatment outcome. RESULTS: In this cohort, 76.0% were cured, 6.6% failed, 4.9% died and 11.5% defaulted. Adverse events were observed in 73.3% of patients, occurring in 74.8% of patients who were adherent (taking at least 80% of prescribed doses) and 59.1% of non-adherent individuals (P = 0.11). The impact of adverse events on outcome was modified by non-adherence; among adherent patients, the occurrence of any adverse reaction was associated with treatment cure (adjusted odds ratio 3.24, 95% confidence interval 1.56-6.70). CONCLUSION: Adverse reactions occurred frequently in MDR-TB patients in Tomsk, Russia, but did not negatively impact treatment outcome. The occurrence of adverse reactions among adherent patients was associated with treatment cure.
Authors:
S S Shin; A D Pasechnikov; I Y Gelmanova; G G Peremitin; A K Strelis; S Mishustin; A Barnashov; Y Karpeichik; Y G Andreev; V T Golubchikova; T P Tonkel; G V Yanova; A Yedilbayev; M L Rich; J S Mukherjee; J J Furin; S Atwood; P E Farmer; S Keshavjee
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease     Volume:  11     ISSN:  1027-3719     ISO Abbreviation:  Int. J. Tuberc. Lung Dis.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-23     Completed Date:  2008-03-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706389     Medline TA:  Int J Tuberc Lung Dis     Country:  France    
Other Details:
Languages:  eng     Pagination:  1314-20     Citation Subset:  IM    
Affiliation:
Division of Social Medicine and Health Inequalities, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. sshin@partners.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Adverse Drug Reaction Reporting Systems
Aged
Antitubercular Agents / adverse effects*
Directly Observed Therapy
Female
Humans
Logistic Models
Male
Middle Aged
Retrospective Studies
Russia / epidemiology
Tuberculosis, Multidrug-Resistant / drug therapy*,  epidemiology
Chemical
Reg. No./Substance:
0/Antitubercular Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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