Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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The Influence of Adverse Drug Reactions on First-line Anti-tuberculosis Chemotherapy in the Elderly Patients

고령에서 일차 항결핵 화학요법에 의한 약물 이상반응이 치료에 미치는 영향

  • Jeong, Jeong Ihm (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Jung, Bock Hyun (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Kim, Mi Hye (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Lim, Jae Min (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Ha, Dong Cheon (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Cho, Sung-Won (Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Rhui, Dae Sik (Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine)
  • 정정임 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 정복현 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 김미혜 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 임재민 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 하동천 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 조성원 (울산대학교 의과대학 강릉아산병원 내과학교실) ;
  • 류대식 (울산대학교 의과대학 강릉아산병원 영상의학교실)
  • Received : 2009.08.04
  • Accepted : 2009.09.07
  • Published : 2009.10.30
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Abstract

Background: Pulmonary tuberculosis (TB) is still common disease among the elderly patients in Korea where the overall incidence of TB is decreasing. Adverse drug reactions (ADR) associated with anti-TB drugs occurs frequently. Especially the aged tends to have more frequent ADRs than younger ones. These ADRs can cause significant morbidity, compromise therapeutic effects of drugs and even induce drug resistance. Therefore we evaluated the effect of ADRs on the first-line anti-TB drugs in elderly patients with active pulmonary TB. Methods: We retrospectively reviewed the charts and radiological findings of the patients with 65 and older who were bacteriologically confirmed as active TB and treated with standard anti-TB drugs for at least 6 months. Major ADR was defined with temporary or continuous stop of any first-line drugs intake. Results: An ADR was noted in 54% of all patients. The incidence of major ADR was 32% in all elderly patients. Dermatologic ADR (9%) was the most common among the major ADRs. GI trouble (8%), arthralgia (6%), visual change (6%), hepatotoxicity (4%), and fever (1%) were also noted. The drugs responsible for major ADR were ethambutol (62%), pyrazinamide (35%), rifampin (18%) and isoniazid (9%). Major ADRs were associated with higher ESR level at the initiation of anti-TB drugs. Conclusion: First-line anti-TB drugs in elderly patients frequently caused the major ADRs. Therefore the elderly patients receiving anti-TB drugs should be closely monitored and better tolerable therapy should be considered as part of a TB research agenda.

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References

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