Evaluation of First Line Anti-Tubercular Therapy Induced Adverse Drug Reactions

Standard anti-TB treatment (ATT) is highly effective and one of the great challenges for ATT success is 4 management of TB drugs toxicity. This toxicity is manifested through adverse drug reactions (ADR) . NTEP, the then RNTCP had adopted thrice weekly regimen for treatment of drug sensitive TB until the year 2016. Various research studies have shown that relapse rates were higher with intermittent regimen. Hence the programme has now shifted to daily regimen for treatment of all drug sensitive TB patients. The adverse drug reactions with daily regimen may be higher compared to intermittent regimen, therefore, it is necessary to clinically monitor the patients on treatment. Objectives: To estimate the proportion of ADR among patients receiving rst line antitubercular drugs in Respiratory Medicine department of AGMC and also to determine the factors associated with ADR in different phases of DOTS therapy. Methodology: Crosssectional study hospital-based observational study and was conducted for a period of 18 months from Jan 2022 to June 2024 at AGMC & GB Pant Hospital in the department of Respiratory Medicine, among newly diagnosed drug sensitive tuberculosis patients of both pulmonary and extra-pulmonary registered for rst-line ATT during the study period Results: In the present study, 105 tuberculosis patients were included. There were 81 male and 24 female patients. Out of total 105 cases diagnosed with Tuberculosis, 60 cases (57.1%) developed ADR and 45 cases (42.8%) did not develop any ADR to First line ATT. It was found that majority of the patients suffered from Liver dysfunction (55%) followed by Gastrointestinal symptoms (20%), Fever (11.67%), Neurological symptoms (6.67%), generalised weakness and allergic drug reactions (3.33% each). Conclusion: A majority of these ADRs occurred during the intensive phase of treatment. Signicant risk factors for developing adverse reactions to antitubercular drugs include male sex, malnutrition, alcohol consumption, cigarette smoking, co-morbidities and having pulmonary tuberculosis. Therefore, healthcare providers treating tuberculosis must identify these vulnerable patient groups to prevent, diagnose, and manage these ADRs. By doing so, patients can adhere to treatment and achieve higher cure rates.