PT  - JOURNAL ARTICLE
AU  - Jihen Ben Amar
AU  - Besma Dhari
AU  - Leila El Gharbi
AU  - Mohamed Ali Baccar
AU  - Saloua Azzabi
AU  - Hichem Aouina
AU  - Hend Bouacha
TI  - Severe adverse effects of antitubercular drugs and patient management
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p4405
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p4405.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p4405.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Introduction: Tuberculosis is an infectious disease which can be totally cured by combining antitubercular drugs. Current therapeutic regimens with isoniazid, rifampicin, pyrazinamide, ethambutol, and streptomycin have proved successful in treating tuberculosis. However, they are associated to a high rate of adverse effects that can lead to therapeutic failure.Patients and methods: We retrospectively reviewed records of patients who present severe adverse effects of antitubercular drugs. We also examined the frequency of and reasons for changing drug regimens.Results: Thirty two patients (20 men) mean age 47 years (18-80 years) were enrolled.Predominant locations of tuberculosis are pulmonary (40%).Cutaneous manifestations were the most frequent (40% of cases), predominantly urticarial associated with fever in 6 cases. Anemia was noted in two cases and thrombocytopenia was noted in one case, anaphylactic shock in two cases, a systemic toxidermia in two cases and renal failure in one patien. Interrupting either one drug or the whole treatment was necessary to define the cause of the reaction. The clinical evolution of hypersensitivity signs was favorable in all cases following definitive withdrawal of the responsible drug. Complete recovery from tuberculosis occurred in all cases.Rifampicin was incriminated in 15 cases, pyrazinamide in 9 cases, isoniazid in 4 cases, streptomycin in 4 cases and Ethambutol in 1 case.Interrupting either one drug or the whole treatment was necessary to define the cause of the reaction. The clinical evolution of hypersensitivity signs was favorable in all cases following definitive withdrawal of the responsible drug. Complete recovery from tuberculosis occurred in all cases