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- Title
Efficacy and safety of cycloserine-containing regimens in the treatment of multidrug-resistant tuberculosis: a nationwide retrospective cohort study in China.
- Authors
Wang, Jing; Pang, Yu; Jing, Wei; Chen, Wei; Guo, Ru; Han, Xiqin; Wu, Limin; Yang, Guangxu; Yang, Kunyun; Chen, Cong; Jiang, Lin; Cai, Chunkui; Dou, Zhi; Diao, Lijuan; Pan, Hongqiu; Wang, Jianyun; Du, Feifei; Xu, Tao; Wang, Lixia; Li, Renzhong
- Abstract
Background: Our aim was to assess whether the use of cycloserine (CS) would bring additional benefit for multidrug-resistant tuberculosis (MDR-TB) patients, and to estimate the incidence and associated risk factors of adverse drug reactions (ADRs) from CS. Patients and methods: In this study, we retrospectively reviewed the clinical outcomes and ADRs of MDR-TB patients treated with CS containing regimens between January 2012 and June 2015 in China. Results: A total of 623 MDR-TB cases enrolled in this study received regimens containing CS. Of these cases, in 411 of the patients 374 (66.0%) were "cured" and 37 (5.9%) "complete treatment" by the end of the study. The elderly, patients with prolonged previous exposure to and history of anti-TB drugs, and pre-existing co-morbidity were more likely to be associated with adverse outcomes of MDR-TB patients (P<0.05). Hyperuricemia (22.8%, 142/623) was the most frequently observed ADR among these cases, while the most noted ADRs associated with the administration of CS was psychiatric symptoms, accounting for 4.3% (27/623) of study population. Nineteen (70.4%) out of 27 cases with psychiatric symptoms occurred before the 6-month timepoint, and were notably, the highest proportion of serious adverse, 29.6% (8/27) of which were noted after discontinuation of CS. Conclusion: Our study demonstrates that a CS-containing regimen achieved a highly successful outcome in the treatment of MDR-TB and promising tolerance in Chinese population. The potential emergence of serious psychiatric symptoms highlights that patients need to be closely monitored for these conditions during treatment that includes CS.
- Subjects
CHINA; MULTIDRUG-resistant tuberculosis; DRUG side effects; TUBERCULOSIS treatment; COHORT analysis; CHINA studies; RETROSPECTIVE studies
- Publication
Infection & Drug Resistance, 2019, Vol 12, p763
- ISSN
1178-6973
- Publication type
Article
- DOI
10.2147/IDR.S194484