Intravenous application of rifampicin and ethambutol in patients with TB treatment failure and impaired suction function of the small intestine

Abstract

Background: The purpose of our work was to study the peculiarities of intravenous application of rifampicin and ethambutol in TB patients with failure of treatment and impaired function of the small intestine. Methods: We observed 49 TB patients with treatment failure and impaired intestinal penetration (IIP). Patients were divided into two groups: Main group (MG) inclu¬ded 20 patients who received intravenously ethambutol (E) (10 ml - 10%) and rifampicin (R) (0.6 g) and orally pyrazinamide (Z, 2 g), isoniazid (H, 0.3 g) in standard doses; Control group (n= 29) received oral standard che¬motherapy - H (0.3 g), R (0.6 g), Z (2 g) and E (1.2 g); 3rd group included 20 relatively healthy individuals. All the patients were with drug-sensitive tuberculosis. The severity of IIP was determined by the concentration of lactulose and mannitol (lactulose-manitol test) in the urine. H, R, E concentration in blood serum was deter¬mined by liquid chromatography. The concentration of anti-tuberculosis drugs (ATDs) was determined in 2,4 and 6 hours after administration. Results: We detected violations of IIP in all the pati¬ents observed, while in Group 3 we did not observe the¬se changes. In the Control group the concentration of ATDs was significantly lower than the average therapeu¬tic concentration, and significant lower than in the Main group (Tab.1) (p < 0.05). The indices regarding the num¬ber of patients who took H were not significant between the Main and Control groups (p> 0.05). Conclusions: In TB patients with treatment failure, vio¬lations of IIP are determined, which leads to a decrease in the concentration of major ATDs in serum and inef¬fective treatment, especially with R and E. To increase the effectiveness of chemotherapy in drug-sensitive TB patients with treatment failure and violation of IIP in¬travenous administration of R and E lead to improve the effectiveness of treatment.