Prevention and mechanism of undesirable adverse reactions in patients with pulmonary tuberculosis with extensive drug-resistance (XDR) combined with type 2 diabetes

Treatment of patients with tuberculosis with XDR combined with diabetes mellitus (DM) is difficult due to the more frequent development of neurotoxic unwanted adverse reactions (UAR) against the background of diabetic neuropathy.Objective: to assess the tolerability of the V chemotherapy regimen, including bedaquiline (Sirturo®) and linezolid (Zivox®) in patients with pulmonary tuberculosis with XDR combined with diabetes when prescribing thioctic acid (Thioctacid®) for the prevention and relief of UAR.126 TB patients with XDR and type 2 DM were observed: main group 1G (n = 66 people) and comparison group 2G (n = 60 people). All patients received V chemotherapy regimen. In addition, Thioctacid® was prescribed to patients in 1G for 6 months; patients of 2G received standard treatment.Before treatment and after 4 months, all patients underwent standard clinical and laboratory examination, as well as the level of glycated hemoglobin (HbA1c) was measured.The average level of HbA1c before the start of treatment in the studied patients was 9.5%, which exceeded the normal values.During treatment, only 7.6% patients of 1G had manifestations of UAR, whereas in 2G – 46.6%. After 6 months, HbA1c level in patients of 1G decreased to 6.3%, and in patients of 2G it remained at 9,8%.After 6 months of treatment in 90.9% of patients of 1G sputum abacilation was achieved. In 2G, bacterial excretion ceased only in 61.7% patients, p<0.05.The use of Thioctacid® in the...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Tuberculosis Source Type: research