ANTITUBERCULOSIS DRUG ALLERGY IN PATIENTS WITH MULTIDRUG-RESISTANT TUBERCULOSIS

Abstract

Objective: To identify allergic reactions (AR) to anti-tuberculosis drugs (ATD) in patients with multidrug-resistant tuberculosis (MDR-TB). Methods: Total of 50 patients with MDR-TB, suspected to develop AR, were enrolled in the study. The patients received standard chemotherapy. The leukocyte lysis sensitization test (LLST) was used to detect delayed-type hypersensitivity. Peripheral blood samples were used to perform 331 tests for AR to nine ATD: isoniazid (H), pyrazinamide (Z), ethambutol (E), levofloxacin (Lfx), cycloserine (Cs), prothionamide (Pt), capreomycin (Cm), p-aminosalicylic acid(PAS) and pyridoxine (B6 ). Study design: retrospective. Results: Tests for AR were positive in 39 patients (78.0%), weakly positive – in 10 patients (20.0%), negative – in 1 patient (2.0%). Analysis of AR prevalence in MDR-TB patients showed that Cs (60.0%), Pt (52.1%), PAS (52.8%), H (54.5%), and Lfx (52.2%) caused AR more frequently than the other ATD. AR to Cm (38.3%), Z (37.8%), E (41.0%), and B6 (38.7%) showed comparable prevalence. Most frequently the patients demonstrated AR to the two ATD (12 patients, 24.0%). Conclusion: AR were detected in 98.0% of 50 examined MDR-TB patients with suspected drug allergy (DA). Cs proved to be the most allergenic drug among others (60.0%). Most frequently the MDR-TB patients demonstrated AR to the two ATD (24.0% of patients).

Keywords

• multidrug-resistant tuberculosis
• drug resistance
• anti-tuberculosis chemotherapy drugs
• allergic reactions.