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Rates and risk factors for nephrotoxicity and ototoxicity among tuberculosis patients in Tbilisi, Georgia.
Buziashvili, M; Mirtskhulava, V; Kipiani, M; Blumberg, H M; Baliashvili, D; Magee, M J; Furin, J J; Tukvadze, N; Kempker, R R.
Afiliação
  • Buziashvili M; Department of Scientific Research, National Center for Tuberculosis and Lung Diseases, Tbilisi.
  • Mirtskhulava V; David Tvildiani Medical University, Tbilisi, Georgia.
  • Kipiani M; Department of Scientific Research, National Center for Tuberculosis and Lung Diseases, Tbilisi.
  • Blumberg HM; Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA, Department of Epidemiology and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA.
  • Baliashvili D; Department of Epidemiology and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, Department of Infectious Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia.
  • Magee MJ; Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA.
  • Furin JJ; Division of Infectious Diseases & HIV Medicine, Case Western Reserve University, Cleveland, OH, USA.
  • Tukvadze N; Department of Scientific Research, National Center for Tuberculosis and Lung Diseases, Tbilisi.
  • Kempker RR; Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA.
Int J Tuberc Lung Dis ; 23(9): 1005-1011, 2019 09 01.
Article em En | MEDLINE | ID: mdl-31615608
SETTING: Treatment of multidrug-resistant tuberculosis (MDR-TB) is lengthy and utilizes second-line anti-TB drugs associated with frequent adverse drug reactions (ADRs).OBJECTIVE: To evaluate the prevalence of and risk factors for ADRs among patients with MDR- and extensively drug-resistant TB (XDR-TB).DESIGN: A retrospective chart review of patients initiating treatment for M/XDR-TB in 2010-2012 in Tbilisi, Georgia.RESULTS: Eighty (54%) and 38 (26%) of 147 patients developed nephrotoxicity per RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease) classification and ototoxicity, respectively. Twenty-five (17%) patients required permanent interruption of injectables due to an ADR. Median hospital stay, total treatment duration and number of regimen changes were higher among those with nephrotoxicity and/or ototoxicity, compared to those without (P < 0.01). Multinomial logistic regression analysis identified increasing age (per year) as a risk factor for nephrotoxicity (aOR 1.08, 95%CI 1.03-1.12) and for both, nephro- and ototoxicity (aOR 1.11, 95%CI 1.05-1.17). Low baseline creatinine clearance (CrCl) was a significant risk factor for developing nephrotoxicity (aOR 1.05, 95%CI 1.02-1.07).CONCLUSION: Second-line injectable drug-related ADRs are common among M/XDR-TB patients. Patients with increasing age and low baseline CrCl should be monitored closely for injectable-related ADRs. Notably, our findings support WHO's latest recommendations on introduction of injectable free anti-TB treatment regimens.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Tuberculose Resistente a Múltiplos Medicamentos / Tuberculose Extensivamente Resistente a Medicamentos / Ototoxicidade / Nefropatias / Antituberculosos Tipo de estudo: Etiology_studies / Guideline / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País como assunto: Europa Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Tuberculose Resistente a Múltiplos Medicamentos / Tuberculose Extensivamente Resistente a Medicamentos / Ototoxicidade / Nefropatias / Antituberculosos Tipo de estudo: Etiology_studies / Guideline / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País como assunto: Europa Idioma: En Ano de publicação: 2019 Tipo de documento: Article