Abstract
It is a routine practice to prescribe prophylactic pyridoxine to patients on TB chemotherapy to prevent Isoniazide induced neuropathy. However this adverse effect seems to be uncommon in our experience. We did a prospective study to determine the incidence of peripheral neuropathy in patients on daily TB chemotherapy. A total of 559 patients on standard daily TB chemotherapy as per WHO categorization were followed throughout the course of treatment. No patient received prophylactic pyridoxine. Patients with proven or suspected drug resistance were excluded from the study. Patients with existing peripheral neuropathy or those suffering from a condition predisposing to neuropathy such as diabetes, were also excluded. Patients reporting with symptoms of peripheral neuropathy such as tingling, numbness and other paraesthesias during the TB chemotherapy were followed. Other causes of neuropathy were ruled out. They were given daily vitamin B-complex (containing Pyridoxine 3 mg) one tablet thrice a day for one week. They were given 100 mg Pyridoxine daily only if there was no response. A total of 26/559 patients (4.65%) developed neuropathy symptoms. 19/26 (73.07%) patients responded to one week course of B-complex and never had recurrence of symptoms. 7/559 (1.25%) patients needed 100 mg of pyridoxine to relieve their symptoms. This indicates very low incidence of peripheral neuropathy in patients on daily TB chemotherapy without use of prophylactic pyridoxine, in Indian scenario.
- © 2011 ERS
