Document Detail


Drug treatment for tuberculosis during pregnancy: safety considerations.
MedLine Citation:
PMID:  11444726     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Untreated tuberculosis in pregnancy poses a significant threat to the mother, fetus and family. Adherence to treatment is especially difficult in pregnancy because of the general fear of any medication and pregnancy-related nausea. Supervised treatment is especially helpful in encouraging adherence. All 4 first line drugs [isoniazid, rifampicin (rifampin), ethambutol and pyrazinamide] have an excellent safety record in pregnancy and are not associated with human fetal malformations. Drug-induced hepatitis, especially with isoniazid, is a significant problem in treating tuberculosis, not peculiar to pregnancy; close monitoring of liver function is recommended. Liver enzyme induction by rifampicin alters the metabolism of other drugs, e.g. methadone doses will need to be increased. Streptomycin should not be used in pregnancy, as perhaps 1 in 6 babies will have problems with hearing and/or balance. Ciprofloxacin has the best safety profile of second line drugs in the treatment of drug-resistant tuberculosis. Preventive treatment with isoniazid can be undertaken safely during pregnancy. Pyridoxine (vitamin B6) should be added to the drug treatment of tuberculosis in all pregnant women taking isoniazid. Neither tuberculin nor the bacille Calmette Guérin (BCG) vaccine are treatments for tuberculosis, but they play an important role in the management of the disease. Tuberculin testing is safe, but BCG vaccination should be avoided in pregnancy and instead given earlier in life.
Authors:
G Bothamley
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Drug safety : an international journal of medical toxicology and drug experience     Volume:  24     ISSN:  0114-5916     ISO Abbreviation:  Drug Saf     Publication Date:  2001  
Date Detail:
Created Date:  2001-07-10     Completed Date:  2001-12-04     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9002928     Medline TA:  Drug Saf     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  553-65     Citation Subset:  IM    
Affiliation:
East London Tuberculosis Service, Homerton Hospital, England. graham.bothamley@homerton-hospital.uk
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MeSH Terms
Descriptor/Qualifier:
Animals
Antitubercular Agents / pharmacology,  therapeutic use*
BCG Vaccine / administration & dosage*
Female
Humans
Patient Compliance
Pregnancy
Pregnancy Complications, Infectious / diagnosis,  drug therapy*,  prevention & control
Recurrence
Tuberculin Test
Tuberculosis / diagnosis,  drug therapy*,  prevention & control
Chemical
Reg. No./Substance:
0/Antitubercular Agents; 0/BCG Vaccine

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


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