The prevalence of adverse drug reactions to a short course anti-tuberculosis regimen |
Sang-Hoon Kim, Byoung-Hoon Lee, Ki-Deok Lee, Jae-Suk Park, Yun-Seop Kim, Young-Koo Jee, Sang-Heon Kim, Hae-Sim Park, Kyoung-Up Min |
서울대학교 의과대학 내과학교실1, 경희대학교 의과대학 내과학교실2 |
원저 : 단기 항결핵 화학요법에 의한 약물 이상반응의 유병률 |
김상훈이병훈이기덕박재석김윤섭지영구김상헌박해심민경, Byoung-Hoon Lee, Ki-Deok Lee, Jae-Suk Park, Yun-Seop Kim, Young-Koo Jee, Sang-Heon Kim, Hae-Sim Park, Kyoung-Up Min |
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Abstract |
Background : Anti-tuberculosis drugs used in combination cause adverse drug reactions, but the prevalence of the
reactions and risk factors have not been determined. This study aims to identify the prevalence and risk factors of
adverse drug reactions (ADR) to the use of first line anti-tuberculosis drugs.
Methods : A total of 435 newly diagnosed patients with tuberculosis (44.1 years¡¾19.0 years) were eligible for this
study. All patients received daily oral isoniazid (300 or 400 mg), rifampicin (450 or 600 mg) and ethambutol (800 mg)
for 6 months, and pyrazinamide (20 mg/kg) for 2 months. Blood tests were performed regularly (before treatment, 2
weeks after treatment, and bimonthly there after). Patients were interviewed 2 months and 6 months after treatment. A
serious ADR was defined as any ADR that resulted in the discontinuation of one or more of the drugs.
Results : An ADR was noted in 52.6% of all patients. Gastrointestinal (19.3%), cutaneous (17.7%), hepatic (13.8%),
renal (12.6%), and neurological (10.3%) ADRs were frequent and hematological (4.4%), musculoskeletal (3.0%) ADRs
were less frequent. A skin ADR was associated with an elevated baseline of liver enzymes (odds ratio, 3.48; 95% CI,
1.2 to 9.9), whereas a hepatic ADR was associated with a history of chronic liver disease (odds ratio, 4.82; 95% CI, 1.7
to 13.2). The prevalence of any serious ADR was 9.7%. Occurrence of any serious ADR was associated with a history
of chronic liver disease (odds ratio, 4.29; 95% CI, 1.4 to 13.6).
Conclusions : Anti-tuberculosis drugs given in combination frequently caused a ADR and the findings suggest that
a patient receiving anti-tuberculosis treatment should be closely monitored.(Korean J Med 73:496-502, 2007) |
Key Words:
Anti-tuberculosis treatment, Adverse drug reaction, Hepatitis |
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