Title: Occurrence of adverse drug reactions in multidrug drug resistant tuberculosis patients with diabetes mellitus

Authors: Dr Girija Nair, Dr Sandhya Kulkarni, Dr Abhay Uppe, Dr Sarang Patil, Dr Prateek Agrawal, Dr Sheena Mathew, Dr Karan Singhal

 DOI: https://dx.doi.org/10.18535/jmscr/v7i1.53

Abstract

 

Introduction: Previous data has suggested a significantly higher risk of adverse outcomes among patients with drug resistant tuberculosis (TB) and diabetes mellitus (DM). The present study was conducted to assess the adverse reactions to anti-tubercular treatment among diabetic and non-diabetic tuberculosis patients.

Methodology: The present study was conducted to describe the side effects of anti-tubercular therapy in patients of TB with and without diabetes mellitus. Equal number of diabetic and non-diabetic (n=75 each) multi-drug resistant (MDR) TB patients who received at least 3 months of anti-TB treatment at our centre were included in the study. All patients in the diabetic group were diagnosed using Genexpert and Mycobacteria growth indicator tube. Adverse drug reactions were determined based on the clinical presentation.

Results: Most common presenting complaint in both the patient groups was cough was almost universal in both the patient groups. Most common side effect reported by the diabetic tuberculosis patients was nausea (in 45%) which had a median onset time of 6 days after starting tuberculosis treatment. Other common adverse effects reported among diabetics was gastritis (43%), vomiting (32%) and peripheral neuropathy (29%). Most common adverse effect reported by patients without diabetes was gastritis which started at a median time of 14 days. Non-diabetics also reported adverse effects like vomiting (49%), dizziness (28%), nausea (28%), peripheral neuropathy (28%) and joint pain (24%).

Conclusions: Screening of DM in TB patients and TB in DM is suggested as high incidence of adverse effects can affect the treatment compliance.

Keywords: MDR tuberculosis, diabetes mellitus, adverse drug reaction.

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Corresponding Author

Dr Sandhya Kulkarni

Assistant Professor, Dept. of Pulmonary Medicine, Dr D. Y. Patil Hospital, Nerul, Navi Mumbai, Maharashtra, India