Aamir Nazir, Sardar Fakhar Imam, Iffat Shabbir, Sehar Saleem.
Adverse drug reactions of first line anti-tuberculosis drugs used in DOTS implemented setting in Lahore.
Pak J Med Res Jan ;54(4):101-4.

Background: Tuberculosis (TB) is a major health problem in most countries despite the availability of effective chemotherapy. The frequency and nature of anti-TB drugs induced adverse drug reactions (ADRs) have been matter of concern in many countries. In our programme patients take their medicines under the direct observation of a health care provider. It is therefore, important to monitor ADRs and increase awareness of health care providers about ADRs and their management. Objective: To get an over view of adverse drug reactions caused by first line anti-tuberculosis drugs used in the treatment of TB cases in directly observed therapy short course (DOTS). Study design, settings and duration: This descriptive observational study was carried out at chest clinic of Sir Ganga Ram Hospital, Lahore for a period of one year. Patients and Methods: Patient aged >15 years of age registered for treatment of tuberculosis in treatment category I at Model Chest Clinic, Sir Ganga Ram Hospital, Lahore were included in the study after obtaining consent. All patients were advised to visit health facility immediately if they had any feeling of drug reaction. Results: A total of 760 TB patients registered in treatment category I were included in the study. Out of 760 patients, 306 (40.2%) patients showed Adverse Drug Reactions (ADR) with anti TB drugs. Joint pain was the most common ADR, reported by 16.7% patients followed by skin itching in 11.5%, anorexia, nausea, abdominal pain in 7.63% and jaundice in 3.68% patients. Rash and visual impairment was reported by 0.26% each. Within gender, ADRs were mostly reported by females (41.9%) as compared to male patients (37.6%). Age wise majority (36%) of ADRs were reported by patients aged between 15-54 years as compared to those aged 55 years or above (4.2%). Most adverse effects settled themselves or with addition of some anti-allergic drugs for few days and in only 4.2% cases one or more ant TB drugs had to be discontinued. Conclusion: ADRs were observed in 40.2% TB patients but most reactions were of mild intensity and settled without any intervention. Only 4.2% reaction were severe enough to stop the drug and replace it with another drug.

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