1. Adverse reactions associated with long-term drug administration in Mycobacterium avium complex lung disease
- Author
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M Matsuki, S Kohno, K. Ohta, A Sato, S Nagoshi, Hideaki Nagai, Y Kamii, M Ohgiya, and M Kawashima
- Subjects
0301 basic medicine ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,030106 microbiology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,medicine ,Mycobacterium avium complex ,030212 general & internal medicine ,Young adult ,Ethambutol ,Creatinine ,biology ,business.industry ,Medical record ,Retrospective cohort study ,biology.organism_classification ,Infectious Diseases ,chemistry ,Antihistamine ,business ,Rifampicin ,medicine.drug - Abstract
Setting The number of patients with non-tuberculous mycobacterial lung disease (NTM-LD) worldwide has been increasing. Mycobacterium avium complex lung disease (MAC-LD) accounts for 90% of NTM-LD. MAC-LD necessitates long-term treatment, but adverse reactions with long-term administration of drugs are poorly understood. Objective To evaluate adverse reactions with long-term administration of drugs for MAC-LD. Design We conducted a retrospective single-centre medical chart review of 364 patients administered two or more drugs between July 2010 and June 2015. Results The prevalence and median time to onset of adverse reactions were as follows: hepatotoxicity 19.5%, 55 days; leucocytopaenia 20.0%, 41 days; thrombocytopaenia 28.6%, 61.5 days; cutaneous reactions 9.3%, 30 days; ocular toxicity 7.7%, 278 days; and increase in serum creatinine 12.4%, 430.5 days. Multivariate analysis showed that rifampicin use was independently associated with thrombocytopaenia, and ethambutol use was independently associated with increases in serum creatinine. Conclusion The main adverse reactions appeared within 3 months after start of treatment. Most patients were able to continue treatment with liver-supporting therapy, antihistamine agents or desensitisation therapy; however, ocular toxicity must be monitored for up to 1 year after start of treatment.
- Published
- 2018
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