Abstract
This study aimed to evaluate hypersensitivity reactions to anti-tuberculosis (TB) drugs. We retrospectively compared the clinical manifestations and treatment outcomes of single and multiple drug hypersensitivity reactions (DHRs). Twenty-eight patients were diagnosed with anti-TB DHRs using oral drug provocation tests. Of these 28 patients, 17 patients (60.7%) had DHRs to a single drug and 11 (39.3%) had multiple DHRs. The median age of patients was 57.5 years (interquartile range [IQR], 39.2-73.2). Of the total patients, 18 patients (64.3%) were men. The median number of anti-TB drugs causing multiple DHRs was 2.0 (IQR 2.0-3.0). Rifampin was the most common drug that caused DHRs in both the single and multiple DHR groups (n = 8 [47.1%] and n = 9 [52.9%], respectively). The treatment success rate was lower in the multiple DHR group than in the single DHR group; however, the difference was not statistically significant (81.8% vs. 94.1%; P = 0.543). Multiple anti-TB DHRs were common in all patients who experienced DHRs, and rifampin was the most common causative drug. The treatment outcomes appeared to be poorer in patients with multiple DHRs than in those with single DHRs.
Highlights
The standard treatment for drug-susceptible tuberculosis (TB) consists of treatment with isoniazid, rifampin, ethambutol, and pyrazinamide for 2 months, followed by treatment with isoniazid and rifampin for 4 months [1]
The treatment success rate was lower in the multiple drug hypersensitivity reactions (DHRs) group than in the single DHR group; the difference was not statistically significant (81.8% vs. 94.1%; P = 0.543)
Multiple anti-TB DHRs were common in all patients who experienced DHRs, and rifampin was the most common causative drug
Summary
A total of 2,347 patients with TB receved anti-TB drugs and 28 patients were diagnosed with DHRs to anti-TB drugs using the oral provocation test (Fig 1). In both groups, most patients had never been treated for TB (94.1% in the single DHR group and 81.8% in the multiple DHR group). The total duration of anti-TB treatment was not significantly different between the single and multiple DHR groups (365.5 days vs 375.0 days; P = 0.610) (Table 5). Comparisons of clinical characteristics, oral provocation test results, and treatment outcomes according to the clinical manifestations of DHRs. The most common clinical manifestation of DHRs in all patients was maculopapular exanthema (MPE) (n = 23, 82.1%) (Table 6).
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