open access

Vol 86, No 4 (2018)
ORIGINAL PAPERS
Published online: 2018-08-15
Submitted: 2018-03-13
Accepted: 2018-08-06
Get Citation

Efficacy and safety of intravenous chemotherapy during intensive treatment phase in patients with newly diagnosed pulmonary tuberculosis

Dmytro Butov, Yurii Feshchenko, Mykhailo Kuzhko, Mykola Gumeniuk, Tetiana Butova
DOI: 10.5603/ARM.a2018.0024
·
Pubmed: 30110116
·
Adv Respir Med 2018;86(4):159-167.

open access

Vol 86, No 4 (2018)
ORIGINAL PAPERS
Published online: 2018-08-15
Submitted: 2018-03-13
Accepted: 2018-08-06

Abstract

Introduction: The purpose of our study was to examine the efficacy and safety of intravenous chemotherapy during intensive
treatment phase in patients with newly diagnosed pulmonary tuberculosis (pulmonary TB).


Material and methods: The study involved 92 patients with newly diagnosed pulmonary TB aged between 20 and 68. All patients
with newly diagnosed pulmonary TB and chemosensitive tuberculosis were enrolled in the study. The patients were allocated to
two groups. The first (control) group of 46 patients received standard chemotherapy orally. The second (main) group consisted
of 46 patients who were prescribed isoniazid, rifampin, ethambutol by i.v. transfusion, and pyrazinamide orally as a part of the
standard treatment.


Results: Symptoms of intoxication and chest manifestations in pulmonary TB patients from the second group were eliminated faster
than the same symptoms in the group 1. In the group 2, the mycobacterial clearance in sputum smears was reduced more rapidly, and up to
2 months it was reached in 37 patients (80.43%), while in the control group in 25 patients (54.35%),p = 0.0066. Destruction
healing and inflitrative change alleviation after 4 months was reached in 38 patients (82.61%) (in control group — 28 (60.87%),
(p = 0.0192). No additional negative effects were detected when compared with the control group at any time.


Conclusions: Thanks to i.v. chemotherapy, clinical manifestations of the in-patients with pulmonary TB were eliminated faster,
severe side effects of anti-TB drugs were not noticed, time of bacterial clearance and healing destruction reduced, healing frequency
of destructions increased and the residual changes decreased.

Abstract

Introduction: The purpose of our study was to examine the efficacy and safety of intravenous chemotherapy during intensive
treatment phase in patients with newly diagnosed pulmonary tuberculosis (pulmonary TB).


Material and methods: The study involved 92 patients with newly diagnosed pulmonary TB aged between 20 and 68. All patients
with newly diagnosed pulmonary TB and chemosensitive tuberculosis were enrolled in the study. The patients were allocated to
two groups. The first (control) group of 46 patients received standard chemotherapy orally. The second (main) group consisted
of 46 patients who were prescribed isoniazid, rifampin, ethambutol by i.v. transfusion, and pyrazinamide orally as a part of the
standard treatment.


Results: Symptoms of intoxication and chest manifestations in pulmonary TB patients from the second group were eliminated faster
than the same symptoms in the group 1. In the group 2, the mycobacterial clearance in sputum smears was reduced more rapidly, and up to
2 months it was reached in 37 patients (80.43%), while in the control group in 25 patients (54.35%),p = 0.0066. Destruction
healing and inflitrative change alleviation after 4 months was reached in 38 patients (82.61%) (in control group — 28 (60.87%),
(p = 0.0192). No additional negative effects were detected when compared with the control group at any time.


Conclusions: Thanks to i.v. chemotherapy, clinical manifestations of the in-patients with pulmonary TB were eliminated faster,
severe side effects of anti-TB drugs were not noticed, time of bacterial clearance and healing destruction reduced, healing frequency
of destructions increased and the residual changes decreased.

Get Citation

Keywords

tuberculosis, treatment of tuberculosis, intravenous treatment of tuberculosis, antituberculous drugs

About this article
Title

Efficacy and safety of intravenous chemotherapy during intensive treatment phase in patients with newly diagnosed pulmonary tuberculosis

Journal

Advances in Respiratory Medicine

Issue

Vol 86, No 4 (2018)

Pages

159-167

Published online

2018-08-15

DOI

10.5603/ARM.a2018.0024

Pubmed

30110116

Bibliographic record

Adv Respir Med 2018;86(4):159-167.

Keywords

tuberculosis
treatment of tuberculosis
intravenous treatment of tuberculosis
antituberculous drugs

Authors

Dmytro Butov
Yurii Feshchenko
Mykhailo Kuzhko
Mykola Gumeniuk
Tetiana Butova

References (30)
  1. World Health Organization, Global Tuberculosis Report 2017: WHO Report 2017. Geneva: WHO : 249.
  2. Dudnyk A, Butov D, Crudu V, et al. MDR-TB in Eastern Europe in the era of the TB elimination action framework. Int J Tuberc Lung Dis. 2017; 21(1): 2–3.
  3. du Toit LC, Pillay V, Danckwerts MP. Tuberculosis chemotherapy: current drug delivery approaches. Respir Res. 2006; 7: 118.
  4. Butov D, Zaitseva S, Butova T, et al. Efficacy and safety of quercetin and polyvinylpyrrolidone in treatment of patients with newly diagnosed destructive pulmonary tuberculosis in comparison with standard antimycobacterial therapy. Int J Mycobacteriol. 2016; 5(4): 446–453.
  5. Horsburgh CR. Tuberculosis. Eur Respir Rev. 2014; 23(131): 36–39.
  6. Falzon D, Schünemann HJ, Harausz E, et al. World Health Organization treatment guidelines for drug-resistant tuberculosis, 2016 update. Eur Respir J. 2017; 49(3).
  7. Mandal S, Chadha VK, Laxminarayan R, et al. Counting the lives saved by DOTS in India: a model-based approach. BMC Med. 2017; 15(1): 47.
  8. Sotgiu G, Sulis G, Matteelli A. Tuberculosis-a World Health Organization Perspective. Microbiol Spectr. 2017; 5(1).
  9. Chaudhry LA, Zamzami M, Aldin S, et al. Clinical consequences of non-compliance with directly observed therapy short course (DOTS): Story of a recurrent defaulter. Int J Mycobacteriol. 2012; 1(2): 99–103.
  10. Mitnick CD, McGee B, Peloquin CA. Tuberculosis pharmacotherapy: strategies to optimize patient care. Expert Opin Pharmacother. 2009; 10(3): 381–401.
  11. Rusen ID, Aït-Khaled N, Alarcón E, et al. Cochrane systematic review of directly observed therapy for treating tuberculosis: good analysis of the wrong outcome. Int J Tuberc Lung Dis. 2017; 11(2): 120–121.
  12. Kendall EA, Azman AS, Cobelens FG, et al. MDR-TB treatment as prevention: The projected population-level impact of expanded treatment for multidrug-resistant tuberculosis. PLoS One. 2017; 12(3): e0172748.
  13. Tiberi S, Buchanan R, Caminero JA, et al. Presse Med. 2017; 46(2 Pt 2): e41–e51.
  14. Peloquin CA. Therapeutic drug monitoring in the treatment of tuberculosis. Drugs. 2002; 62(15): 2169–2183.
  15. Kimerling M, Phillips P, Patterson P, et al. Low Serum Antimycobacterial Drug Levels in Non-HIV-Infected Tuberculosis Patients. Chest. 1998; 113(5): 1178–1183.
  16. Nahid P, Dorman SE, Alipanah N, et al. Executive summary: official American Thoracic Society/Centers for disease control and prevention/infectious diseases society of America Clinical Practice Guidelines: treatment of drug-susceptible tuberculosis. Clin Infect Dis. 2016; 63(7): 853–867.
  17. Gupta S, Cheung L, Pokkali S, et al. Suppressor Cell-Depleting Immunotherapy With Denileukin Diftitox is an Effective Host-Directed Therapy for Tuberculosis. J Infect Dis. 2017; 215(12): 1883–1887.
  18. Thiam S, LeFevre AM, Hane F, et al. Effectiveness of a strategy to improve adherence to tuberculosis treatment in a resource-poor setting: a cluster randomized controlled trial. JAMA. 2007; 297(4): 380–386.
  19. Peloquin CA, MacPhee AA, Berning SE. Malabsorption of antimycobacterial medications. N Engl J Med. 1993; 329(15): 1122–1123.
  20. Nuermberger E, Grosset J. Pharmacokinetic and pharmacodynamic issues in the treatment of mycobacterial infections. Eur J Clin Microbiol Infect Dis. 2004; 23(4): 243–255.
  21. Ruslami R, Ganiem A, Dian S, et al. Intensified regimen containing rifampicin and moxifloxacin for tuberculous meningitis: an open-label, randomised controlled phase 2 trial. The Lancet Infectious Diseases. 2013; 13(1): 27–35.
  22. Mehta J, Shantaveerapa H, Byrd R, et al. Utility of rifampin blood levels in the treatment and follow-up of active pulmonary tuberculosis in patients who were slow to respond to routine directly observed therapy. Chest. 2001; 120(5): 1520–1524.
  23. Drabkina PO, Bwanga F. Methods for determination of drug resistance of Mycobacterium tuberculosis and bacteriostatic activity of the blood of patients with tuberculosis: methodical letter. Kyiv: Zdorovya. 1969: 117–135.
  24. Lapach SN, Chubenko AV, Babich PN. Statistical methods in biomedical studies using excel. Kyiv: Morion; 2000. 2014: 320.
  25. Antonenko P, Butov D, Kresyun V, et al. Association between effectiveness of tuberculosis treatment and cytochrome P-4502E1 polymorphism of the patients. Int J Mycobacteriol. 2017; 6(4): 396–400.
  26. World Health Organization. Guidelines for treatment of tuberculosis fourth edition: World Health Organization. Geneva: WHO; 2010 147.
  27. World Health Organization. Treatment of tuberculosis: guidelines. Geneva: WHO; 2010. 160.
  28. World Health Organization. TB CARE I. International Standards for Tuberculosis Care, Edition 3. Geneva: WHO; 2014 214.
  29. Schwenk A, Macallan DC. Tuberculosis, malnutrition and wasting. Curr Opin Clin Nutr Metab Care. 2000; 3(4): 285–291.
  30. Bloom BR. Tuberculosis: Pathogenesis, Protection, and Control. Washington: ASM Press. 1994.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Czasopismo Pneumonologia i Alergologia Polska dostęne jest również w Ikamed - księgarnia medyczna

Wydawcą serwisu jest "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl