SIDE EFFECTS OF SECOND-LINE ANTITUBERCULOSIS DRUGS IN MULTI-DRUG RESISTANCE (MDR) TUBERCULOSIS PATIENTS
Main Article Content
Multidrug-resistant tuberculosis (MDR TB) is caused by Mycobacterium tuberculosis strains resistant to isoniazid and rifampicin—the most potent anti-TB drugs. Prolonged treatment duration and complex drug regimens often lead to poor adherence, contributing to high MDR TB incidence and low treatment success rates, particularly in Indonesia. This study analyzed drug utilization patterns in 52 MDR TB patients at Dr. Mohammad Hoesin Hospital Palembang, using total sampling based on medical records from October 2018 to December 2019. Data were analyzed descriptively with SPSS v25. The most common side effects reported were weakness, nausea, and vomiting (84.6%), followed by arthralgia, hyperuricemia, and hearing loss (42.3%). Severe side effects were more prevalent in the short-term regimen group (40.4%) compared to the long-term group (7.7%). Weakness, nausea, and vomiting were the most frequently observed side effects in MDR TB patients.
Keywords:
MDR-TB
Anti-Tuberculosis Drug
Side Effect
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2. Aung KJM, Van Deun A, Declercq E, Sarker MR, Das PK, Hossain MA, et al. Successful ‘9-month Bangladesh regimen’ for multidrug-resistant tuberculosis among over 500 consecutive patients. The International Journal of Tuberculosis and Lung Disease. 2014 Oct 1;18(10):1180–7.
3. Chaudhary A, Sarraf D, Bhattarai N, Chaudhary A, Rauniar G. Clinical Profile, Drug Utilization Pattern and Adverse Drug Reactions of Anti-tubercular Drugs at DOTS Center in a Tertiary Hospital. Nepal Medical College Journal. 2020 Nov 2;22(3):158–66.
4. Chhabra N, Aseri ML, Dixit R, Gaur S. Pharmacotherapy for multidrug resistant tuberculosis. J Pharmacol Pharmacother. 2012 Apr;3(2):98–104.
5. Deshkar AM, Bhardwaj P, Manoharrao Deshkar A, Verma R. Side Effects Encountered in Treatment of Multidrug-resistant Tuberculosis: A 3-Year Experience at First Dots Plus Site of Chhattisgarh. Int J Sci Study [Internet]. 2015; Available from: www.ijss-sn.com
6. Gerdan V, Akkoc N, Ucan E, Bulac Kir S. Paradoxical increase in uric acid level with allopurinol use in pyrazinamide-induced hyperuricaemia. Singapore Med J. 2013 Jun;54(6):e125–6.
7. Huth ME, Ricci AJ, Cheng AG. Mechanisms of Aminoglycoside Ototoxicity and Targets of Hair Cell Protection. Int J Otolaryngol. 2011;2011:1–19.
8. Inoue T, Ikeda N, Kurasawa T, Sato A, Nakatani K, Ikeda T, et al. [Hyperuricemia and arthralgia during pyrazinamide treatment]. Nihon Kokyuki Gakkai Zasshi. 1999 Feb;37(2):115–8.
9. Kusumo Sutoyo D, Melati Munir S, Nawas A, Soetoyo DK, Pulmonologi dan Ilmu Kedokteran Respirasi FKUI-RS Persahabatan Jakarta D. Pengamatan Pasien Tuberkulosis Paru dengan Multidrug Resistant (TB-MDR) di Poliklinik Paru RSUP Persahabatan Pneumococcal Pneumonia View project Pulmonary Involvement in Connective Tissue Diseases View project Pengamatan Pasien Tuberkulosis Paru dengan Multidrug Resistant (TB-MDR) di Poliklinik Paru RSUP Persahabatan [Internet]. Vol. 30, J Respir Indo. 2010. Available from: https://www.researchgate.net/publication/283479338
10. Madhav B, Iyer A, Jayalakshmi TK. Side effect profile of 2 nd line drugs in multi drug resistant (MDR) and extensively drug resistant (XDR) tuberculosis. In: 102 Tuberculosis. European Respiratory Society; 2015. p. PA2708.
11. Mason CY, Prieto A, Bogati H, Sannino L, Akai N, Marquardt T. Adverse events using shorter MDR-TB regimens: outcomes from Port Moresby, Papua New Guinea. Public Health Action. 2021 Mar 21;11(1):2–4.
12. Muñoz-Torrico M, Caminero-Luna J, Migliori GB, D’Ambrosio L, Carrillo-Alduenda JL, Villareal-Velarde H, et al. Diabetes is Associated With Severe Adverse Events in Multidrug-Resistant Tuberculosis. Archivos de Bronconeumología (English Edition). 2017 May;53(5):245–50.
13. Nunn AJ, Phillips PPJ, Meredith SK, Chiang CY, Conradie F, Dalai D, et al. A Trial of a Shorter Regimen for Rifampin-Resistant Tuberculosis. New England Journal of Medicine. 2019 Mar 28;380(13):1201–13.
14. Nunn AJ, Rusen I, Van Deun A, Torrea G, Phillips PP, Chiang CY, et al. Evaluation of a standardized treatment regimen of anti-tuberculosis drugs for patients with multi-drug-resistant tuberculosis (STREAM): study protocol for a randomized controlled trial. Trials. 2014 Dec 9;15(1):353.
15. Park HO, Kim SH, Moon SH, Byun JH, Kim JW, Lee CE, et al. Association between Body Mass Index and Sputum Culture Conversion among South Korean Patients with Multidrug Resistant Tuberculosis in a Tuberculosis Referral Hospital. Infect Chemother. 2016;48(4):317.
16. Persatuan Dokter Paru Indonesia (PDPI). The latest News Of Tuberculosis. Vol. 1. Fakultas Kedokteran Universitas Sebelas Maret; 2018.
17. Pham AQ, Doan A, Andersen M. Pyrazinamide-induced hyperuricemia. P T. 2014 Oct;39(10):695–715.
18. PODEWILS LJ, HOLTZ T, RIEKSTINA V, SKRIPCONOKA V, ZAROVSKA E, KIRVELAITE G, et al. Impact of malnutrition on clinical presentation, clinical course, and mortality in MDR-TB patients. Epidemiol Infect. 2011 Jan 30;139(1):113–20.
19. PRATIWI NKAC, YOWANI SC, SAJINADIYASA IGK. HUBUNGAN LAMA PENGGUNAAN OBAT ANTI TUBERKULOSIS DENGAN EFEK SAMPING PADA PASIEN TB MDR RAWAT JALAN DI RSUP SANGLAH DENPASAR. ARCHIVE OF COMMUNITY HEALTH. 2016 Dec;3(2):39–48.
20. Reviono, Kusnanto P, Eko V, Pakiding H, Nurwidiasih D. Multidrug Resistant Tuberculosis (MDR-TB): Tinjauan Epidemiologi dan Faktor Risiko Efek Samping Obat Anti Tuberkulosis. Majalah Kedokteran Bandung. 2014;46(4):189–96.
21. Saktiawati AMI, Subronto YW. Influence of Diabetes Mellitus on the Development of Multi Drug Resistant-Tuberculosis in Yogyakarta. Acta Med Indones. 2018 Jan;50(1):11–7.
22. Sanger GJ, Andrews PLR. A History of Drug Discovery for Treatment of Nausea and Vomiting and the Implications for Future Research. Front Pharmacol. 2018 Sep 4;9.
23. Sinha P, Davis J, Saag L, Wanke C, Salgame P, Mesick J, et al. Undernutrition and Tuberculosis: Public Health Implications. J Infect Dis. 2019 Apr 16;219(9):1356–63.
24. UYAINAH NA. Tuberkulosis Tinjauan Dan Tata Laksana Komprehensif Terkini. Vol. 2018.
25. Verrest L, Wilthagen EA, Beijnen JH, Huitema ADR, Dorlo TPC. Influence of Malnutrition on the Pharmacokinetics of Drugs Used in the Treatment of Poverty-Related Diseases: A Systematic Review. Clin Pharmacokinet. 2021 Sep 1;60(9):1149–69.
26. World Health Organization. Global Tuberculosis Report 2020. 2020.
27. Yang TW, Park HO, Jang HN, Yang JH, Kim SH, Moon SH, et al. Side effects associated with the treatment of multidrug-resistant tuberculosis at a tuberculosis referral hospital in South Korea. Medicine. 2017 Jul;96(28):e7482.
28. Yang TW, Park HO, Jang HN, Yang JH, Kim SH, Moon SH, et al. Side effects associated with the treatment of multidrug-resistant tuberculosis at a tuberculosis referral hospital in South Korea. Medicine. 2017 Jul;96(28):e7482.
