E B Vladimirova, E I Shmelev, A S Zaytseva, S A Kasimtseva, E I Shchepikhin, T G Smirnova, N N Makaryants
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Before and during treatment, a study of clinical, biochemical blood tests, urinalysis, electrocardiogram, external respiration function, ultrasound of the abdominal organs and kidneys was performed.</p><p><strong>Results: </strong>Under the conditions of antimicrobial therapy (AMT) for non-tuberculous mycobacteriosis of the lungs, 41 (27.9%) patients developed adverse drug reaction (ADR). The most frequent adverse reactions were: allergic reactions in the form of urticaria, nausea, vomiting, arthralgia, nephro- and ototoxic reactions; 34 (82.9%) patients required treatment adjustment without discontinuation of AMT, and only in 7 (17.1%) cases, AMT was discontinued. A full course of multicomponent AMT was completed in 124 (84.4%) patients with NTML. An algorithm for monitoring therapy in NTML patients from the standpoint of preventing ADR has been developed. The categories of patients with potential risks of developing ADR under AMT were determined. Patients without the development of ADR had a positive radiological dynamics in 27.9% of cases, sputum conversion - in 42%. Patients with ADR had positive clinical dynamics in 39% of cases, radiological - in 31.7% of cases, sputum conversion - in 36.6% of cases.</p><p><strong>Conclusion: </strong>The incidence of ADR development remains high when complex AMT is administered to patients with NTML. The patient's comorbid background is the main risk factor for the development of ADR when prescribing multicomponent AMT. A multivariate analysis of the effectiveness of treatment in NTML patients showed comparable data among patients taking complex AMT and receiving only alternative therapies. The success of NTML treatment depends on a comprehensive personalized approach.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"96 11","pages":"1049-1055"},"PeriodicalIF":0.3000,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Adverse reactions in the treatment of patients with non-tuberculous lung mycobacterial pulmonary disease and the possibility of their solution].\",\"authors\":\"E B Vladimirova, E I Shmelev, A S Zaytseva, S A Kasimtseva, E I Shchepikhin, T G Smirnova, N N Makaryants\",\"doi\":\"10.26442/00403660.2024.11.202992\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>To study the adverse reactions that develop as a result of complex antibiotic therapy in patients with non-tuberculous lung mycobacterial (NTML) and to determine methods for their elimination without compromising the effectiveness of NTML treatment.</p><p><strong>Materials and methods: </strong>Examined 147 patients with confirmed NTML, for which they received treatment in accordance with the results of drug susceptibility of the pathogen. Before and during treatment, a study of clinical, biochemical blood tests, urinalysis, electrocardiogram, external respiration function, ultrasound of the abdominal organs and kidneys was performed.</p><p><strong>Results: </strong>Under the conditions of antimicrobial therapy (AMT) for non-tuberculous mycobacteriosis of the lungs, 41 (27.9%) patients developed adverse drug reaction (ADR). The most frequent adverse reactions were: allergic reactions in the form of urticaria, nausea, vomiting, arthralgia, nephro- and ototoxic reactions; 34 (82.9%) patients required treatment adjustment without discontinuation of AMT, and only in 7 (17.1%) cases, AMT was discontinued. A full course of multicomponent AMT was completed in 124 (84.4%) patients with NTML. An algorithm for monitoring therapy in NTML patients from the standpoint of preventing ADR has been developed. The categories of patients with potential risks of developing ADR under AMT were determined. Patients without the development of ADR had a positive radiological dynamics in 27.9% of cases, sputum conversion - in 42%. Patients with ADR had positive clinical dynamics in 39% of cases, radiological - in 31.7% of cases, sputum conversion - in 36.6% of cases.</p><p><strong>Conclusion: </strong>The incidence of ADR development remains high when complex AMT is administered to patients with NTML. The patient's comorbid background is the main risk factor for the development of ADR when prescribing multicomponent AMT. A multivariate analysis of the effectiveness of treatment in NTML patients showed comparable data among patients taking complex AMT and receiving only alternative therapies. The success of NTML treatment depends on a comprehensive personalized approach.</p>\",\"PeriodicalId\":22209,\"journal\":{\"name\":\"Terapevticheskii Arkhiv\",\"volume\":\"96 11\",\"pages\":\"1049-1055\"},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2024-12-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Terapevticheskii Arkhiv\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.26442/00403660.2024.11.202992\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Terapevticheskii Arkhiv","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.26442/00403660.2024.11.202992","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
[Adverse reactions in the treatment of patients with non-tuberculous lung mycobacterial pulmonary disease and the possibility of their solution].
Aim: To study the adverse reactions that develop as a result of complex antibiotic therapy in patients with non-tuberculous lung mycobacterial (NTML) and to determine methods for their elimination without compromising the effectiveness of NTML treatment.
Materials and methods: Examined 147 patients with confirmed NTML, for which they received treatment in accordance with the results of drug susceptibility of the pathogen. Before and during treatment, a study of clinical, biochemical blood tests, urinalysis, electrocardiogram, external respiration function, ultrasound of the abdominal organs and kidneys was performed.
Results: Under the conditions of antimicrobial therapy (AMT) for non-tuberculous mycobacteriosis of the lungs, 41 (27.9%) patients developed adverse drug reaction (ADR). The most frequent adverse reactions were: allergic reactions in the form of urticaria, nausea, vomiting, arthralgia, nephro- and ototoxic reactions; 34 (82.9%) patients required treatment adjustment without discontinuation of AMT, and only in 7 (17.1%) cases, AMT was discontinued. A full course of multicomponent AMT was completed in 124 (84.4%) patients with NTML. An algorithm for monitoring therapy in NTML patients from the standpoint of preventing ADR has been developed. The categories of patients with potential risks of developing ADR under AMT were determined. Patients without the development of ADR had a positive radiological dynamics in 27.9% of cases, sputum conversion - in 42%. Patients with ADR had positive clinical dynamics in 39% of cases, radiological - in 31.7% of cases, sputum conversion - in 36.6% of cases.
Conclusion: The incidence of ADR development remains high when complex AMT is administered to patients with NTML. The patient's comorbid background is the main risk factor for the development of ADR when prescribing multicomponent AMT. A multivariate analysis of the effectiveness of treatment in NTML patients showed comparable data among patients taking complex AMT and receiving only alternative therapies. The success of NTML treatment depends on a comprehensive personalized approach.
期刊介绍：
Терапевтический архив
The journal was founded by the prominent Russian therapists M.P. Konchalovsky and G.F. Lang in 1923. Then its editors-in-chief were Professors V.N. Vinogradov and A.G. Gukasyan. Since 1972, E.I. Chazov, Academician of the Russian Academy of Sciences, has been heading the editorial board of the journal.
Over 90 years, there have been more than 1000 issues where the authors and editorial staff have done their best for readers to keep abreast of current advances in medical science and practice and for physicians to master the advanced principles of recognition and treatment of a wide spectrum of visceral diseases.
The papers published in the journal (editorials, original articles, lectures, reviews, etc.) cover both current scientific achievements and practical experience in diagnosing, treating, and preventing visceral diseases. The authors of publications are not only Russian, but also foreign scientists and physicians. All papers are peer-reviewed by highly qualified Russian specialists.
The journal is published monthly. Traditionally, each issue has predominantly certain thematic areas covering individual therapy specializations. Every year, one of the issues is devoted to related problems in practical medicine (allergology and immunology, neurology and psychiatry, obstetrics, oncology, etc.). This all draws the attention of the reading public to the journal.
The journal is indexed in RSCI (Russian Science Citation Index), PubMed/Medline, Index Medicus, Scopus/EMBASE, Web of Science Core Collection (Science Citation Index Expanded), Web of Science (Russian Science Citation Index - RSCI, Current Contents Connect, BIOSIS Previews), Google Scholar, Ulrich''s Periodicals Directory.
The journal is included in the list of periodicals recommended by the Higher Attestation Committee for publishing the papers containing the basic materials of doctoral and candidate dissertations.
By the decision of the Presidium of the Russian Academy of Medical Sciences, the “Therapevticheskiy Arkhiv” was awarded the Botkin medal. It was admitted to the European Association of Sciences Editors (EASE).
The journal was honored with the Golden Press Fund decoration at the 13th International Press Professional Exhibition.
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