Adverse Effects in Multidrug-Resistant Tuberculosis Treatment
Summary
Treatment of multidrug-resistant tuberculosis (MDR-TB) relies on prolonged use of second-line agents that carry a high burden of toxicity and complicate global control efforts. Common adverse effects encompass hepatotoxicity, nephrotoxicity, ototoxicity, peripheral neuropathy, gastrointestinal disturbances and psychiatric symptoms. These may arise early or late in the course of therapy and often necessitate dose reduction, interruption or substitution of key drugs. Serious events such as hearing loss from aminoglycosides, myelosuppression with linezolid and severe skin reactions from cycloserine can undermine adherence, fostering further resistance and treatment failure. Risk factors include advanced age, comorbidities (including HIV and diabetes), anaemia and low body mass index. In resource-limited settings, pharmacovigilance systems are frequently inadequate to detect and manage adverse drug reactions (ADRs), leading to under-reporting and delayed intervention. Improving patient outcomes requires standardised monitoring protocols, systematic symptom screening and integration of audiological and laboratory assessments. Recent shifts towards shorter, less toxic regimens and repurposed agents underscore the need for real-time evaluation of safety profiles to balance efficacy with tolerability. The development of all-oral, injectable-sparing regimens promises to reduce the global burden of MDR-TB-related morbidity, but robust surveillance remains essential to guide clinical decision-making and optimise programme performance.
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Adverse Effects in Multidrug-Resistant Tuberculosis Treatment publication trend
The graph below shows the total number of articles in adverse effects in multidrug-resistant tuberculosis treatment across all publications each year (not limited to Nature Index journals).
Technical terms
Multidrug-resistant tuberculosis (MDR-TB): Tuberculosis caused by Mycobacterium tuberculosis strains that are resistant to at least isoniazid and rifampicin.
Adverse drug reaction (ADR): Any noxious, unintended response to a medicinal product used at normal dosages for prophylaxis, diagnosis or therapy.
Extensively drug-resistant tuberculosis (XDR-TB): MDR-TB strains with additional resistance to any fluoroquinolone and at least one second-line injectable agent (amikacin, kanamycin or capreomycin).
References
- Drug hypersensitivity in drug-resistant tuberculosis. World Allergy Organization Journal (2023).
- Safety Profile of Medicines Used for the Treatment of Drug-Resistant Tuberculosis: A Descriptive Study Based on the WHO Database (VigiBase®). Antibiotics (2023).
- Incidence and predictors of major adverse drug events among drug-resistant tuberculosis patients on second-line anti-tuberculosis treatment in Amhara regional state public hospitals; Ethiopia: a retrospective cohort study. BMC Infectious Diseases (2019).
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