title: Incidence and risk factors for drug intolerance and association with incomplete treatment for tuberculosis: analysis of national case registers for England, Wales and Northern Ireland, 2001-2010.
abstract: Anti-tuberculosis drug regimens are efficacious, but drug intolerance can be severe and may impact on treatment completion rates. The Enhanced Tuberculosis Surveillance (ETS) system is a case register of all new notifications of tuberculosis in England, Wales and Northern Ireland. We conducted a cohort study to estimate the incidence of, and risk factors for, drug intolerance reported through ETS between 2001 and 2010 and to assess its relationship with treatment non-completion. Reports of drug intolerance were found for 868/67,547 (1.28%) patients in the cohort, and important risk factors were female sex, older age, later case report year and white ethnicity. Drug intolerance was associated with an approximate fivefold increased odds of treatment non-completion (p<0.001). These results highlight the need for better-tolerated drug regimens and close case management of patients at risk of drug intolerance to improve treatment completion rates and contribute to more effective disease control.
authors: Field Epidemiology Services - Cambridge, Public Health England, UK Department of Infection and Population Health, Centre for Infectious Disease Epidemiology, University College London, London, UK.
authors: Catherine
authors: C
authors: Smith
authors: Department of Infection and Population Health, Centre for Infectious Disease Epidemiology, University College London, London, UK Respiratory Diseases Department, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK MRC Clinical Trials Unit, University College London, London, UK.
authors: Ibrahim
authors: I
authors: Abubakar
authors: Respiratory Diseases Department, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK.
authors: H Lucy
authors: HL
authors: Thomas
authors: Respiratory Diseases Department, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK.
authors: Laura
authors: L
authors: Anderson
authors: Respiratory Medicine, Royal Free London NHS Foundation Trust, London, UK Division of Medicine, University College London, London, UK.
authors: Marc
authors: M
authors: Lipman
authors: Field Epidemiology Services - Cambridge, Public Health England, UK.
authors: Mark
authors: M
authors: Reacher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004198:Disease Susceptibility; D024901:Drug Resistance, Multiple, Bacterial; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009660:Northern Ireland / Q000453:epidemiology; D011159:Population Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology*; D014852:Wales / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents
keywords: Tuberculosis