Adverse effects of antituberculosis drugs.

Abstract

Antituberculosis chemotherapeutic regimens do not often cause serious toxicity. When reactions do occur, they must be correctly and rapidly managed so that effective treatment is not unnecessarily interrupted or the patient exposed to the risk of acquired resistance. All the drugs can cause hypersensitivity reactions, particularly streptomycin, thiacetazone and paraaminosalicylic acid, but alternative drugs are readily available. However, if it is necessary to desensitise the patient, this can usually be achieved. Transient symptomless increases in serum liver enzyme concentrations are common during the early weeks of antituberculosis treatment, but these are not clinically important and must be distinguished from clinically evident hepatitis which may occur in up to approximately 1 % of patients. When hepatitis occurs, treatment should be interrupted until liver function tests are again normal. Treatment, even with the same drugs, can then usually be resumed uneventfully.