Alternative anti-tuberculosis regimen including ofloxacin for the treatment of patients with hepatic injury.
METHODS
Tuberculosis (TB) clinic of a university-based public hospital in Rio de Janeiro city, Brazil.


OBJECTIVE
To describe treatment outcomes for TB patients with liver injury who received a 12-month regimen of ethambutol (E, EMB) and ofloxacin (O, OFL), including streptomycin (S, SM) for the first 3 months (3SEO/9EO) under routine clinical care conditions.


METHODS
A retrospective study of a cohort of TB patients prescribed 3SEO/9EO was conducted over a 66-month period. Data were obtained by review of existing medical records. Primary outcomes assessed were cure, treatment failure, treatment default, TB relapse and death.


RESULTS
Outcomes were assessed for 40 patients with hepatic injury who met study criteria. Twenty-three (58%) were male and 13 (33%) were human immunodeficiency virus seropositive. Thirty-four (85%) patients were cured. Three patients (7.5%) defaulted from treatment, and three other patients died (7.5%). There were no treatment failures or relapses during 2 years of follow-up. Clinically recognized drug toxicity occurred in five patients (12.5%), and in each case was attributed to SM.


CONCLUSIONS
In this series of TB patients with serious liver injury, 3SEO/9EO was well-tolerated, and it was effective in 85% of patients when used under routine clinical care conditions.
Szklo
A
A
Instituto de Doenças do Torax/Hospital Universitario Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Brazil.
Mello
F C Q
FC
Guerra
R L
RL
Dorman
S E
SE
Muzy-de-Souza
G R
GR
Conde
M B
MB
D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001938:Brazil; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006779:Hospitals, Public; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D008111:Liver Function Tests; D008297:Male; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D016017:Odds Ratio; D015242:Ofloxacin / Q000008:administration & dosage / Q000009:adverse effects; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013307:Streptomycin / Q000008:administration & dosage / Q000009:adverse effects; D015996:Survival Rate; D017211:Treatment Failure; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D014505:Urban Population
D000995:Antitubercular Agents; D004977:Ethambutol; D015242:Ofloxacin; D013307:Streptomycin