Effectiveness of Intravenous Isoniazid and Ethambutol Administration in Patients with Tuberculosis Meningoencephalitis and HIV Infection

Tuberculosis and Respiratory Diseases

article

Dmytro Butov¹  Yurii Feshchenko²  Mykhailo Kuzhko³  Mykola Gumenuik²  Kateryna Yurko⁴  Alina Grygorova⁵  Anton Tkachenko⁶  Natalia Nekrasova⁷  Tetiana Tlustova⁸  Vasyl Kikinchuk⁹  Alexandr Peshenko⁹  Tetiana Butova^1,10 

[1] Department of Phthisiology and Pulmonology, Kharkiv National Medical University;Department of Technologies of Treatment of Nonspecific Lung Diseases, National Institute of Phthisiology and Pulmonology named after F. G. Yanovskyi NAMS of Ukraine;Department of Resistent Tuberculosis, National Institute of Phthisiology and Pulmonology named after F. G. Yanovskyi NAMS of Ukraine;Department of Infectious Diseases, Kharkiv National Medical University;Department of Research, Kharkiv National Medical University;Department of Biochemistry, Kharkiv National Medical University;Department of Neurology, Kharkiv National Medical University;Department of Medicine, National Institute of Phthisiology and Pulmonology named after F. G. Yanovskyi NAMS of Ukraine;Department of Criminalistics and Forensic Science, Kharkiv National University of Internal Affairs;Department of Internal Medicine, V.N. Karazin Kharkiv National University

关键词: Tuberculosis;    Tuberculous Meningitis;    Human Immunodeficiency Virus;    Treatment;    Isoniazid;    Ethambutol;   

DOI  :  10.4046/trd.2019.0021

学科分类：医学（综合）

来源: The Korean Academy of Tuberculosis and Respiratory Diseases

【 摘 要 】

Background The aim of this study was to investigate the effectiveness of intravenous isoniazid (H) and ethambutol (E) administered in patients with new sputum positive drug-susceptible pulmonary tuberculosis (TB) with tuberculous meningoencephalitis (TM) and human immunodeficiency virus (HIV) co-infection in the intensive phase of treatment. Methods Fifty-four patients with TB/TM and HIV co-infection were enrolled for this study. Group 1 comprised of 23 patients treated with E and H intravenously, while rifampicin and pyrazinamide were prescribed orally. Group 2 consisted of 31 patients treated with the first-line anti-TB drugs orally. The concentrations of H and E in blood serum were detected using a chromatographic method. Results A significant improvement in the clinical symptoms and X-ray signs in patients treated intravenously with H and E was observed and compared to group 2. The sputum Mycobacterium tuberculosis positivity was observed during the second month of the treatment in 25.0% of patients from group 1 and 76.1% of the patients from the control group (p=0.003). In addition, nine patients (39.1%) died up to 6 months when H and E were prescribed intravenously compared with 22 (70.9%) in group 2 (p=0.023). Conclusion In TB/TM with HIV, the intravenous H and E treatment was more effective than oral H and E treatment at 2 months of intensive treatment in sputum conversion as well as in clinical improvement, accompanied by significantly higher mean serum concentrations. In addition, the mortality rate was lower in intravenous H and E treatment compared to oral treatment.

【 授权许可】

CC BY-NC