Effectiveness of Intravenous Isoniazid and Ethambutol

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Date

2019-08-31

Authors

Butov, Dmytro
Feshchenko, Yurii
Kuzhko, Mykhailo
Gumeniuk, Mykola
Yurko, Kateryna
Grygorova, Alina
Tkachenko, Anton
Nekrasova, Natalia
Tlustova, Tetiana
Kikinchuk, Vasyl

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Abstract

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.

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Keywords

tuberculosis, tuberculous meningitis, Human immunodeficiency virus (HIV), treatment, Isoniazid, Ethambutol

Citation

Effectiveness of Intravenous Isoniazid and Ethambutol / D. Butov, Yu. Feshchenko, M. Kuzhko, M. Gumenuik, K. Yurko, A. Grygorova, A. Tkachenko, N. Nekrasova, T. Tlustova, V. Kikinchuk, A. Peshenko, T. Butova // Tuberculosis and Respiratory Diseases. – 2019. – Vol.82. – P. 1–8. – DOI: https://doi.org/10.4046/trd.2019.0021.

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