Applications of infusion therapy in the difficult form of tuberculosis

Abstract

Objective. Analysis of the prevalence of the difficult cases of tuberculosis (TB) and assessment of the effectiveness of the treatment when using infusion anti-TB drugs in standard regimens.
 Materials and methods. A retrospective analysis was carried out for 2017-2019 of the electronic database the register of patients and the inpatient case history KU “Chernivtsi Regional Clinical TB Dispensary”.
 Results and discussion. From 16 to 46 % of patients with TB infection have concomitant signs of diabetes mellitus. In 58.9 % of patients with sensitive TB, the absorption capacity of the small intestine significantly decreases with a predominant decrease in the intestinal permeability index from 3.1 to 6 (in 21.9 % of cases). At multiple-drug resistance TB decrease the absorptive function of intestines is observed in 76,1 % of cases with the prevalence of severe degree of disturbance (in 42,3 % of patients). The proportion of severe forms of sensitive TB is more than 42 % of cases, of which 69.6±1.6 % were diagnosed with destruction. The share of common forms of TB among all cases of drug-resistant TB (DRTB) treated in 4th categories is 47 %, of which with destructive forms – 78.5±3.6 %. The frequency of adverse reactions increases in severe forms of DRTB and amounts to 38 % of all analyzed cases.
 Conclusions. Early detection of patients with severe forms of TB, especially in the presence of concomitant pathology, and their allocation into a separate category of “severe patients with TB” using parenteral forms of anti-TB drugs, especially in the early stages of treatment (during the intensive phase, which is the most critical period), it facilitates to reduce the unfavorable prognosis of the course of the underlying disease.