Efficacy and safety profile of 2nd line Anti TB drugs in DRTB patients in a tertiary care hospital of South Punjab.

Abstract

The objective of the study was to assess the efficacy and safety profile of 2nd line Anti TB drugs in DR TB patients in a tertiary care hospital of South Punjab. This retrospective cohort study included patients who received therapy for multidrug-resistant tuberculosis (MDR-TB) between March 2018 and June 2021 at the Pulmonology Department of Sheikh Zayed Hospital, Rahim Yar Khan. Sociodemographic data, TB treatment history, treatment schemes, safety profiles, weight measures, and sputum smear results were obtained from medical records. Outcome variables of interest included body weight, sputum smear grading for treatment efficacy, and ADRs for safety assessment. The study showed a progressive decline in positive sputum smear results over the 24-month treatment for MDR-TB, with an increase in negative smear results from 33 (9.50%) at baseline to 97 (28.0%) by Month 24. Furthermore, the mean body weight significantly increased every three months throughout the trial. Beginning at 43.83 kg at baseline, the mean weight increased to 50.02 kg by the end of 24 months. ADRs were mostly mild to moderate, including depression (18.4%), arthralgia (17.1%), anxiety (16.5%), and Qtc prolongation (11.0%). The treatment adhered to international guidelines, using a tailored combination of second-line drugs and adjusting regimens based on drug resistance patterns from sputum culture and DST. The study findings suggest the efficacy of second-line anti-TB drug regimens in achieving sputum smear conversion and positive treatment outcomes in patients with MDR-TB. However, the occurrence of ADRs highlights the need for careful monitoring and management during treatment.