Rizwan Hafiz Muhammad, Atif Moazzam Ali, Hussain Mazhar, Nazeer Rimsha
Hafiz Muhammad Rizwan, FCPS. Department of Pulmonology, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, Pakistan.
Moazzam Ali Atif, FCPS. Department of Pharmacology, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, Pakistan.
Pak J Med Sci. 2024 Dec;40(11):2665-2674. doi: 10.12669/pjms.40.11.8605.
The objective of the study was to assess the efficacy and safety profile of 2nd line Anti TB drugs in DR TB patients in a tertiary care hospital of South Punjab.
This retrospective cohort study included patients who received therapy for multidrug-resistant tuberculosis (MDR-TB) between March 2018 and June 2021 at the Pulmonology Department of Sheikh Zayed Hospital, Rahim Yar Khan. Sociodemographic data, TB treatment history, treatment schemes, safety profiles, weight measures, and sputum smear results were obtained from medical records. Outcome variables of interest included body weight, sputum smear grading for treatment efficacy, and ADRs for safety assessment.
The study showed a progressive decline in positive sputum smear results over the 24-month treatment for MDR-TB, with an increase in negative smear results from 33 (9.50%) at baseline to 97 (28.0%) by Month 24. Furthermore, the mean body weight significantly increased every three months throughout the trial. Beginning at 43.83 kg at baseline, the mean weight increased to 50.02 kg by the end of 24 months. ADRs were mostly mild to moderate, including depression (18.4%), arthralgia (17.1%), anxiety (16.5%), and Qtc prolongation (11.0%). The treatment adhered to international guidelines, using a tailored combination of second-line drugs and adjusting regimens based on drug resistance patterns from sputum culture and DST.
The study findings suggest the efficacy of second-line anti-TB drug regimens in achieving sputum smear conversion and positive treatment outcomes in patients with MDR-TB. However, the occurrence of ADRs highlights the need for careful monitoring and management during treatment.
本研究的目的是评估南旁遮普邦一家三级医院中二线抗结核药物治疗耐多药结核病（DR-TB）患者的疗效和安全性。
这项回顾性队列研究纳入了2018年3月至2021年6月期间在拉希姆亚尔汗谢赫扎耶德医院肺病科接受耐多药结核病（MDR-TB）治疗的患者。从医疗记录中获取社会人口统计学数据、结核病治疗史、治疗方案、安全性、体重测量结果和痰涂片结果。感兴趣的结局变量包括体重、治疗疗效的痰涂片分级以及用于安全性评估的药物不良反应（ADR）。
研究表明，在24个月的MDR-TB治疗期间，痰涂片阳性结果逐渐下降，阴性涂片结果从基线时的33例（9.50%）增加到第24个月时的97例（28.0%）。此外，在整个试验过程中，平均体重每三个月显著增加。基线时平均体重为43.83千克，到24个月末平均体重增加到50.02千克。药物不良反应大多为轻度至中度，包括抑郁（18.4%）、关节痛（17.1%）、焦虑（16.5%）和Qtc延长（11.0%）。治疗遵循国际指南，使用二线药物的定制组合，并根据痰培养和药物敏感性试验（DST）的耐药模式调整治疗方案。
研究结果表明二线抗结核药物治疗方案在耐多药结核病患者中实现痰涂片转阴和取得积极治疗效果方面具有疗效。然而，药物不良反应的发生凸显了治疗期间进行仔细监测和管理的必要性。
