Ichiki Hiraku, Watanabe Akira, Ueda Seiya, Sato Chika, Abe Masahiro
Department of Internal Medicine, National Hospital Organization (NHO) Ehime National Hospital, Japan.
Kekkaku. 2012 Jul;87(7):487-90.
Adverse drug reactions interfere with the standard treatment of pulmonary Mycobacterium avium complex (MAC) disease; however, few studies have investigated this issue. We studied adverse drug reactions in the treatment of pulmonary MAC disease.
We retrospectively examined 74 patients who underwent treatment for pulmonary MAC disease in our hospital between January 2001 and December 2009. These patients had received treatment with rifampicin, ethambutol (EB), and clarithromycin. We analyzed the adverse drug reactions seen in these patients.
Twenty-two patients developed one or more adverse drug reactions that led to treatment discontinuation or change in medication, whereas 52 patients did not experience any adverse reactions. The incidence rate of adverse reactions was 29.7%. The adverse drug reactions included visual impairment in 9 patients, liver function disorder in 2, skin eruption in 5, and fever in 5. In most of the cases, the standard treatment could not be continued.
Visual impairment associated with EB was the most common adverse drug reaction, and it led to the discontinuation of EB, and thus the standard treatment. Additionally, in case of other adverse drug reactions, it was difficult to find appropriate replacements for the causative drugs. Further investigations are required to establish a standard policy for the management of adverse drug reactions that can lead to the discontinuation of chemotherapy.
药物不良反应干扰了鸟分枝杆菌复合群（MAC）肺病的标准治疗；然而，很少有研究调查过这个问题。我们研究了MAC肺病治疗中的药物不良反应。
我们回顾性检查了2001年1月至2009年12月期间在我院接受MAC肺病治疗的74例患者。这些患者接受了利福平、乙胺丁醇（EB）和克拉霉素治疗。我们分析了这些患者出现的药物不良反应。
22例患者出现一种或多种药物不良反应，导致治疗中断或用药改变，而52例患者未出现任何不良反应。不良反应发生率为29.7%。药物不良反应包括9例视力损害、2例肝功能障碍、5例皮疹和5例发热。在大多数情况下，无法继续进行标准治疗。
与EB相关的视力损害是最常见的药物不良反应，它导致EB停药，从而中断标准治疗。此外，对于其他药物不良反应，很难找到合适的药物替代引起不良反应的药物。需要进一步研究以制定药物不良反应管理的标准策略，这些不良反应可能导致化疗中断。
