Publication: Management of antitubercular drugs-induced hepatotoxicity and therapy reintroduction strategy in a TB clinic of Nepal
Date
2005
Authors
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Publisher
Kathmandu University
Abstract
Background: PZA, INH and R have potential for hepatotoxic side effects. Although anti-tuberculosis drug-induced
hepatotoxicity is well known, there is no agreement on the clinical approach for cases in whom hepatotoxicity has
developed. Objective: To study the management of anti-TB-drugs induced hepatotoxicity and the standard anti-TB
drugs therapy reintroduction procedure. Design: In prospective cohort analysis, 4 patients with active TB infection
had developed anti-TB drugs induced hepatotoxicity. Retreatment of therapy was done on the basis of severity of
hepatitis. If damage is mild, all the drugs were reintroduced at once in a tapering dose and if patient’s condition is
worse, INH and E is introduced in lower dose, later increasing the dose and the number of drugs. Results: All the
patients tolerated anti-TB drugs well after reintroduction. There was no incidence of recurrence. All the patients
completed their 8 months treatment regimen and all are cured. Conclusion: Timely detection and temporary
withdrawal of the offending agent can completely cure anti-TB drugs-induced hepatotoxicity. The recurrence of
hepatotoxicity is rare if reintroduction in done in a well planned manner.