단기 항결핵 화학요법에 의한 약물 이상반응의 유병률
The prevalence of adverse drug reactions to a short course anti-tuberculosis regimen
김상훈, 이병훈, 이기덕, 박재석, 김윤섭, 지영구, 김상헌, 박해심, 민경업,
소속 상세정보
김상훈 ( Kim Sang-Hoon )
을지대학교 의과대학 내과학교실
이병훈 ( Lee Byoung-Hoon )
을지대학교 의과대학 을지병원 내과
이기덕 ( Lee Ki-Deok )
을지대학교 의과대학 을지병원 내과
박재석 ( Park Jae-Seuk )
단국대학교 의과대학 내과학교실
김윤섭 ( Kim Youn-Seup )
단국대학교 의과대학 내과학교실
지영구 ( Jee Young-Koo )
단국대학교 의과대학 내과학교실
김상헌 ( Kim Sang-Heon )
한양대학교 의과대학 내과학교실
박해심 ( Park Hae-Sim )
아주대학교 의과대학 내과학교실
민경업 ( Min Kyung-Up )
서울대학교 의과대학 내과학교실
KMID : 0882420070730050496
Abstract
Background : Anti-tuberculosis drugs used in combination cause adverse drug reactions, but the prevalence of the reactions and risk factors have not been determined. This study aims to identify the prevalence and risk factors of adverse drug reactions (ADR) to the use of first line anti-tuberculosis drugs.
Methods : A total of 435 newly diagnosed patients with tuberculosis (44.1 years+/-19.0 years) were eligible for this study. All patients received daily oral isoniazid (300 or 400 mg), rifampicin (450 or 600 mg) and ethambutol (800 mg) for 6 months, and pyrazinamide (20 mg/kg) for 2 months. Blood tests were performed regularly (before treatment, 2 weeks after treatment, and bimonthly there after). Patients were interviewed 2 months and 6 months after treatment. A serious ADR was defined as any ADR that resulted in the discontinuation of one or more of the drugs.
Results : An ADR was noted in 52.6% of all patients. Gastrointestinal (19.3%), cutaneous (17.7%), hepatic (13.8%), renal (12.6%), and neurological (10.3%) ADRs were frequent and hematological (4.4%), musculoskeletal (3.0%) ADRs were less frequent. A skin ADR was associated with an elevated baseline of liver enzymes (odds ratio, 3.48; 95% CI, 1.2 to 9.9), whereas a hepatic ADR was associated with a history of chronic liver disease (odds ratio, 4.82; 95% CI, 1.7 to 13.2). The prevalence of any serious ADR was 9.7%. Occurrence of any serious ADR was associated with a history of chronic liver disease (odds ratio, 4.29; 95% CI, 1.4 to 13.6).
Conclusion : Anti-tuberculosis drugs given in combination frequently caused a ADR and the findings suggest that a patient receiving anti-tuberculosis treatment should be closely monitored.
키워드
Anti-tuberculosis treatment; Adverse drug reaction; Hepatitis
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