Tolerance and side effects of second line anti tubercular drugs

Abstract

Introduction: Second line anti tubercular drugs are associated with lot of side effects which can be severe. The aim was to evaluate tolerance and adverse reactions of those drugs in patients treated for tuberculosis (TB). Methods: We review retrospectively data of 74 patients with TB treated by Second line anti TB drugs followed up between 2012 and 2016 in respiratory department (C) in Abderahmen Mami Hospital. Results: Out of 74 patients, 33 patients experienced adverse drug reactions second line anti TB drugs. Sex ratio was 2,3. The mean of age was 37 years (14-78). Patients were smokers (66,7%), drug addicts (15,2%) and alcoholic (45,5%). Indication of second anti TB drugs was the TB resistance (n=32) and multiple anti TB drugs allergy (n=1). According to type of resistance, acquired resistance was 42 % and primary resistance was 58%. The comorbidities associated with TB were diabetes (24%), chronic lung disease (18%) and psychiatric disorders in 12%. Side effects of drugs were gastrointestinal manifestations (n=16), ototoxicity (n=10), arthralgia (n=8), skin reaction (n=4), vision disorder (n=3), peripheral neuritis (n=2). Most of the drugs’ side effects started to appear within the first 3 months of treatment (2 days-1 year). Drug intolerance didn’t affect daily activities of 20 patients, but limit it in 11 cases, and two needed to be hospitalized. Suspected drug was reduced in 3 cases, fractionation of the dose was necessary in 13 cases and drug removal in 11 cases. Specific treatment for side effect was administrated in 6 cases. Conclusion: Second line anti TB drugs are associated with multiple side effects. Comorbidities major intolerance risk. Early management of intolerance is necessary to improve TB prognosis.