[Experience of rapid drug desensitization therapy in the treatment of mycobacterial disease].
BACKGROUND
Drugs for tuberculosis and non-tuberculosis mycobacterial diseases are limited. In particular, no new drugs for non-tuberculosis mycobacterial disease have been developed in recent years. Antimycobacterial drugs have many adverse reactions, for which drug desensitization therapy has been used.


OBJECTIVE
Rapid drug desensitization (RDD) therapy, including antituberculosis drugs and clarithromycin, has been implemented in many regions in Europe and the United States. We investigated the validity of RDD therapy in Japan.


METHODS
We report our experience with RDD therapy in 13 patients who developed severe drug allergy to antimycobacterial treatment. The desensitization protocol reported by Holland and Cernandas was adapted.


RESULTS
The underlying diseases were 7 cases of pulmonary Mycobacterium avium complex disease and 6 cases of pulmonary tuberculosis. Isoniazid was readministered in 2 (100%) of 2 patients; rifampicin, in 8 (67.7%) of 12 patients; ethambutol, in 4 (67.7%) of 6 patients; and clarithromycin, in 2 (100%) of 2 patients.


CONCLUSIONS
In Japan, the desensitization therapy recommended by the Treatment Committee of the Japanese Society for Tuberculosis have been implemented generally. We think RDD therapy is effective and safe as the other desensitization therapy. We will continue to investigate the efficiency of RDD therapy in patients who had discontinued antimycobacterial treatment because of the drug allergic reaction.
Yuka
Y
Sasaki
Atsuyuki
A
Kurashima
Kozo
K
Morimoto
Masao
M
Okumura
Masato
M
Watanabe
Takashi
T
Yoshiyama
Hideo
H
Ogata
Hajime
H
Gotoh
Shoji
S
Kudoh
Hiroaki
H
Suzuki
D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003888:Desensitization, Immunologic; D004342:Drug Hypersensitivity / Q000276:immunology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000188:drug therapy*; D013997:Time Factors; D014376:Tuberculosis / Q000188:drug therapy*
D000900:Anti-Bacterial Agents