Analysis of Occurrence and Clinical Characteristics of Cycloserine-related Adverse Drug Reactions in Patients with Multidrug-resistant Tuberculosis
Objective:To explore the occurrence and clinical characteristics of cycloserine-related adverse drug reactions(ADRs)in patients with multidrug-resistant tuberculosis(MDR-TB),and provide reference for the clinical medication safety of cycloserine in patients with MDR-TB.Methods:182 MDR-TB patients admitted to the Fifth People's Hospital of Suzhou from January 1,2018 to December 31,2021 were selected as the research subjects,and the information such as patient's age,gender,occupation,tuberculosis type,treatment outcome,use of cycloserine,and occurrence of related ADRs was collected,focusing on analyzing the occurrence and clinical characteristics of cycloserine-related ADRs in MDR-TB patients.Results:After excluding those who were lost to follow-up,died,and did not use cycloserine from 182 MDR-TB patients,there were only 167 cases.Among them,134 cases were successfully treated,with a treatment success rate of 80.24%;among 167 patients,ADRs occurred in 10 cases,with the incidence of 5.99%.The Naranjo's Assessment Scale showed that the correlation scores between 10 cases of ADRs and cycloserine were 5-8 points,i.e.the correlation was"very likely";the occurrence time of 10 cases of ADRs was 4 to 361 days(median:67.5 days)after medication,and their clinical manifestations were the toxicity symptoms of central nerves(such as suicidal tendency,insanity,severe insomnia,anxiety,depression,lethargy,etc.).After cycloserine was discontinued or the dosage of vitamin B6 was increased,the toxicity symptoms of central nerves of 10 patients were relieved or disappeared.Conclusion:The cycloserine-based anti-tuberculosis treatment regimen has a good curative effect on MDR-TB patients;meanwhile,the incidence of cycloserine-related toxicity symptoms of central nerves is relatively low,but the symptoms are more serious.Therefore,clear instructions should be given during medication propaganda and education to patients to ensure the medication safety of patients.
multidrug-resistant tuberculosiscycloserineadverse drug reactionstoxicity symptoms of central nervesclinical characteristics
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