TY - JOUR
T1 - Hepatitis associated with prothionamide for treatment of multidrug-resistant tuberculosis
AU - Hsu, Han Lin
AU - Bai, Kuan Jen
AU - Chiang, Yi Chun
AU - Lin, Shian Jiun
AU - Yu, Ming Chih
N1 - Funding Information:
This study was supported by the MDR-TB program of the Centers for Disease Control, Department of Health, Taiwan.
PY - 2010/12
Y1 - 2010/12
N2 - Timely and intensive monitoring for, and management of, adverse effects caused by anti-tuberculosis drugs are essential components of control programs for multidrug-resistant tuberculosis (MDR-TB). This retrospective case series was conducted in northern Taiwan from January 2007 to December 2008 at Taipei Medical University-Wan Fang Hospital, a 750-bed tertiary-care center and MDR-TB referral center. Hepatitis associated with prothionamide was defined as the recurrence of hepatitis after a second prothionamide treatment re-challenge. In total, 47 patients with MDR-TB enrolled in the Directly Observed Therapy, Short Course-Plus Program were identified during the study period, and 44 (93.6%) were treated with prothionamide. Seven of these 44 patients (15.9%) developed hepatitis after being treated with prothionamide concurrent with other anti-tuberculosis agents. Hepatitis associated with prothionamide occurred in three of these seven patients (6.8%). In these three patients, hepatitis developed following treatment with prothionamide for 28 days, 39 days or 45 days. Hepatitis developed rapidly after re-challenge with prothionamide at 4 days, 4 days and 3 days, respectively. Liver function returned to the normal range after cessation of prothionamide treatment for 19 days, 27 days or 28 days. Close monitoring of liver function was necessary in MDR-TB patients who received prothionamide treatment.
AB - Timely and intensive monitoring for, and management of, adverse effects caused by anti-tuberculosis drugs are essential components of control programs for multidrug-resistant tuberculosis (MDR-TB). This retrospective case series was conducted in northern Taiwan from January 2007 to December 2008 at Taipei Medical University-Wan Fang Hospital, a 750-bed tertiary-care center and MDR-TB referral center. Hepatitis associated with prothionamide was defined as the recurrence of hepatitis after a second prothionamide treatment re-challenge. In total, 47 patients with MDR-TB enrolled in the Directly Observed Therapy, Short Course-Plus Program were identified during the study period, and 44 (93.6%) were treated with prothionamide. Seven of these 44 patients (15.9%) developed hepatitis after being treated with prothionamide concurrent with other anti-tuberculosis agents. Hepatitis associated with prothionamide occurred in three of these seven patients (6.8%). In these three patients, hepatitis developed following treatment with prothionamide for 28 days, 39 days or 45 days. Hepatitis developed rapidly after re-challenge with prothionamide at 4 days, 4 days and 3 days, respectively. Liver function returned to the normal range after cessation of prothionamide treatment for 19 days, 27 days or 28 days. Close monitoring of liver function was necessary in MDR-TB patients who received prothionamide treatment.
KW - Hepatitis
KW - Multidrug-resistant tuberculosis
KW - Prothionamide
UR - http://www.scopus.com/inward/record.url?scp=79951889240&partnerID=8YFLogxK
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U2 - 10.1016/S0929-6646(10)60141-6
DO - 10.1016/S0929-6646(10)60141-6
M3 - Article
C2 - 21195892
AN - SCOPUS:79951889240
SN - 0929-6646
VL - 109
SP - 923
EP - 927
JO - Journal of the Formosan Medical Association
JF - Journal of the Formosan Medical Association
IS - 12
ER -