Alternative anti-tuberculosis regimen including ofloxacin for the treatment of patients with hepatic injury

Int J Tuberc Lung Dis. 2007 Jul;11(7):775-80.

Abstract

Setting: Tuberculosis (TB) clinic of a university-based public hospital in Rio de Janeiro city, Brazil.

Objective: To describe treatment outcomes for TB patients with liver injury who received a 12-month regimen of ethambutol (E, EMB) and ofloxacin (O, OFL), including streptomycin (S, SM) for the first 3 months (3SEO/9EO) under routine clinical care conditions.

Design: A retrospective study of a cohort of TB patients prescribed 3SEO/9EO was conducted over a 66-month period. Data were obtained by review of existing medical records. Primary outcomes assessed were cure, treatment failure, treatment default, TB relapse and death.

Results: Outcomes were assessed for 40 patients with hepatic injury who met study criteria. Twenty-three (58%) were male and 13 (33%) were human immunodeficiency virus seropositive. Thirty-four (85%) patients were cured. Three patients (7.5%) defaulted from treatment, and three other patients died (7.5%). There were no treatment failures or relapses during 2 years of follow-up. Clinically recognized drug toxicity occurred in five patients (12.5%), and in each case was attributed to SM.

Conclusion: In this series of TB patients with serious liver injury, 3SEO/9EO was well-tolerated, and it was effective in 85% of patients when used under routine clinical care conditions.

Publication types

  • Comparative Study

MeSH terms

  • Antitubercular Agents / administration & dosage*
  • Antitubercular Agents / adverse effects
  • Brazil
  • Cohort Studies
  • Comorbidity
  • Confidence Intervals
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Ethambutol / administration & dosage
  • Ethambutol / adverse effects
  • Female
  • Follow-Up Studies
  • Hospitals, Public
  • Humans
  • Liver Diseases / diagnosis
  • Liver Diseases / drug therapy*
  • Liver Diseases / epidemiology*
  • Liver Function Tests
  • Male
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / isolation & purification
  • Odds Ratio
  • Ofloxacin / administration & dosage
  • Ofloxacin / adverse effects
  • Recurrence
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Streptomycin / administration & dosage
  • Streptomycin / adverse effects
  • Survival Rate
  • Treatment Failure
  • Treatment Outcome
  • Tuberculosis, Pulmonary / diagnosis
  • Tuberculosis, Pulmonary / drug therapy*
  • Tuberculosis, Pulmonary / epidemiology*
  • Urban Population

Substances

  • Antitubercular Agents
  • Ethambutol
  • Ofloxacin
  • Streptomycin