Efficacy and safety of quercetin and polyvinylpyrrolidone in treatment of patients with newly diagnosed destructive pulmonary tuberculosis in comparison with standard antimycobacterial therapy

Abstract

The objective/background of this work was to study the efficacy and safety of quercetin and polyvinylpyrrolidone (QP) in the treatment of patients with newly diagnosed destructive pulmonary tuberculosis in comparison with standard antimycobacterial therapy. Materials and methods: The study involved 124 patients aged between 20 years and 70 years with newly diagnosed destructive pulmonary tuberculosis. Patients were allocated to two groups. The first (control) group of patients received standard antimycobacterial and pathogenetic therapy and included 31 (25.00±3.89 %) patients. The second (main) group of patients received QP therapy in addition to chemotherapy and included 93 (75.00±3.89%) patients. All patients received standard chemotherapy, consisting of orally administered isoniazid (0.3 g), rifampicin (0.6 g), pyrazinamide (2 g), ethambutol (1.2 g), and/or an intramuscular injection of streptomycin (1 g) with a dose reduction after the intensive phase of the therapy. Theanti-TB drugs were procured through the Ukraine’s centralized national supply system. QP was used in a dose of 0.5 g in 100 mL of 0.9% sodium chloride solution intravenously once per day for 10 days starting on admission to the hospital. Results: Intoxication symptoms in the second group were reduced following 1.33±0.15 months, whereas in the first group intoxication symptoms were reduced following 2.64 ± 0.20 months, p < .001. Moreover, respiratory symptoms regression in the second group was observed following (1.43±0.30) months, whereas in the first group – following (2.33±0.30) months, p<0.05. Bacillary excretion period evaluated within 3 months was reduced, as it was shown by (97.67±1.63%) in the main group compared to (72.41±8.45%), p<0.05, in the control group. In addition, period of cavities healing was reduced to (2.86±0.15) months in the main group compared to (3.43±0.20) months, p<0.05, in the control group. Residual radiological lung damage findings (mild or slight or even no signs) were observed in 84 (90.32±3.07 %) patients of the main group versus 22 (70.97±8.15 %) patients in the control group. Significant residual radiological lung damage findings were observed in 9 (9.68±3.07 %) patients of the main group and in 9 (29.03±8.15 %) patients of the control group, p<0.05. In addition, QP provides anti-TB drugs tolerance increase by 20.42% and has immunomodulatory effect. Conclusion: Administration of QP combined with chemotherapy in patients with newly diagnosed destructive pulmonary tuberculosis resulted in a comparatively quick reduction of disease manifestation.