Thioacetazone

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Alimuddin Zumla - One of the best experts on this subject based on the ideXlab platform.

  • Best drug treatment for multidrug-resistant and extensively drug-resistant tuberculosis
    The Lancet. Infectious diseases, 2010
    Co-Authors: Jose A. Caminero, Alimuddin Zumla, Giovanni Sotgiu, Giovanni Battista Migliori
    Abstract:

    Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis are generally thought to have high mortality rates. However, many cases can be treated with the right combination and rational use of available antituberculosis drugs. This Review describes the evidence available for each drug and discusses the basis for recommendations for the treatment of patients with MDR and XDR tuberculosis. The recommended regimen is the combination of at least four drugs to which the Mycobacterium tuberculosis isolate is likely to be susceptible. Drugs are chosen with a stepwise selection process through five groups on the basis of efficacy, safety, and cost. Among the first group (the oral first-line drugs) high-dose isoniazid, pyrazinamide, and ethambutol are thought of as an adjunct for the treatment of MDR and XDR tuberculosis. The second group is the fluoroquinolones, of which the first choice is high-dose levofloxacin. The third group are the injectable drugs, which should be used in the following order: capreomycin, kanamycin, then amikacin. The fourth group are called the second-line drugs and should be used in the following order: thioamides, cycloserine, then aminosalicylic acid. The fifth group includes drugs that are not very effective or for which there are sparse clinical data. Drugs in group five should be used in the following order: clofazimine, amoxicillin with clavulanate, linezolid, carbapenems, Thioacetazone, then clarithromycin.

  • human immunodeficiency virus type 1 infection in zambian children with tuberculosis changing seroprevalance and evaluation of a Thioacetazone free regimen
    Tubercle and Lung Disease, 1994
    Co-Authors: C. Luo, Chifumbe Chintu, Ganapati Bhat, Mario Raviglione, Vinod K. Diwan, Herbert L. Dupont, Alimuddin Zumla
    Abstract:

    Setting: This study was conducted at the Department of Paediatrics and Child Health, University Teaching Hospital (UTH), in Lusaka, Zambia. Objectives: To monitor the seroprevalence of HIV type-1 in children with tuberculosis and to evaluate the response to anti-tuberculosis therapy using a Thioacetazone-free treatment regimen. Design: A prospective cross-sectional study of all consecutive newly diagnosed cases of TB in children from 1 month-15 years of age seen at the University Teaching Hospital (UTH) in Lusaka, Zambia between 1 October 1991 and 31 May 1992. Results: 120 children with a clinical diagnosis of tuberculosis and 167 controls were enrolled in the study. The overall HIV type-1 seroprevalence rate in children with tuberculosis was 55.8% (67120) compared to 9.6% (16167) amongst the control group (P < 0.0001: odds ratio = 11.50; 95% CI = 5.99−22.7). Common clinical presentations among children with TB were bronchopneumonia (45162), miliary TB (30162) and tuberculous lymphadenopathy (2133). There were no significant differences in clinical presentation of TB between the HIV-negative and HIV-positive groups. The follow-up of those patients with tuberculosis was poor, with only 65 patients (55%) returning to the clinic for scheduled appointments after discharge. All the 16 patients who died did so within 60 days of discharge from hospital; all of them were seropositive for HIV. There were no deaths among the HIV-negative group. Despite the exclusion of Thioacetazone from the treatment regimen, cutaneous reactions occurring within 8 weeks of commencing treatment were observed in 7 of the 65 (11%) patients, 2 of whom developed fatal Stevens-Johnson syndrome. AH 7 patients were seropositive for HIV-1. Conclusions: The seroprevalence rate of HIV type-1 among children with tuberculosis in Lusaka continues to rise; careful monitoring of anti-TB therapy (even in regimens excluding Thioacetazone) for potentially lethal side effects should be carried out.

  • Human immunodeficiency virus type-1 infection in Zambian children with tuberculosis: changing seroprevalance and evaluation of a Thioacetazone-free regimen.
    Tubercle and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 1994
    Co-Authors: C. Luo, Chifumbe Chintu, Ganapati Bhat, Mario Raviglione, Vinod K. Diwan, Herbert L. Dupont, Alimuddin Zumla
    Abstract:

    This study was conducted at the Department of Paediatrics and Child Health, University Teaching Hospital (UTH), in Lusaka, Zambia. To monitor the seroprevalence of HIV type-1 in children with tuberculosis and to evaluate the response to anti-tuberculosis therapy using a Thioacetazone-free treatment regimen. A prospective cross-sectional study of all consecutive newly diagnosed cases of TB in children from 1 month-15 years of age seen at the University Teaching Hospital (UTH) in Lusaka, Zambia between 1 October 1991 and 31 May 1992. 120 children with a clinical diagnosis of tuberculosis and 167 controls were enrolled in the study. The overall HIV type-1 seroprevalence rate in children with tuberculosis was 55.8% (67/120) compared to 9.6% (16/167) amongst the control group (P < 0.0001: odds ratio = 11.50; 95% CI = 5.99-22.7). Common clinical presentations among children with TB were bronchopneumonia (45/162), miliary TB (30/162) and tuberculous lymphadenopathy (21/33). There were no significant differences in clinical presentation of TB between the HIV-negative and HIV-positive groups. The follow-up of those patients with tuberculosis was poor, with only 65 patients (55%) returning to the clinic for scheduled appointments after discharge. All the 16 patients who died did so within 60 days of discharge from hospital; all of them were seropositive for HIV. There were no deaths among the HIV-negative group. Despite the exclusion of Thioacetazone from the treatment regimen, cutaneous reactions occurring within 8 weeks of commencing treatment were observed in 7 of the 65 (11%) patients, 2 of whom developed fatal Stevens-Johnson syndrome. All 7 patients were seropositive for HIV-1. The seroprevalence rate of HIV type-1 among children with tuberculosis in Lusaka continues to rise; careful monitoring of anti-TB therapy (even in regimens excluding Thioacetazone) for potentially lethal side effects should be carried out.

Mario Raviglione - One of the best experts on this subject based on the ideXlab platform.

  • human immunodeficiency virus type 1 infection in zambian children with tuberculosis changing seroprevalance and evaluation of a Thioacetazone free regimen
    Tubercle and Lung Disease, 1994
    Co-Authors: C. Luo, Chifumbe Chintu, Ganapati Bhat, Mario Raviglione, Vinod K. Diwan, Herbert L. Dupont, Alimuddin Zumla
    Abstract:

    Setting: This study was conducted at the Department of Paediatrics and Child Health, University Teaching Hospital (UTH), in Lusaka, Zambia. Objectives: To monitor the seroprevalence of HIV type-1 in children with tuberculosis and to evaluate the response to anti-tuberculosis therapy using a Thioacetazone-free treatment regimen. Design: A prospective cross-sectional study of all consecutive newly diagnosed cases of TB in children from 1 month-15 years of age seen at the University Teaching Hospital (UTH) in Lusaka, Zambia between 1 October 1991 and 31 May 1992. Results: 120 children with a clinical diagnosis of tuberculosis and 167 controls were enrolled in the study. The overall HIV type-1 seroprevalence rate in children with tuberculosis was 55.8% (67120) compared to 9.6% (16167) amongst the control group (P < 0.0001: odds ratio = 11.50; 95% CI = 5.99−22.7). Common clinical presentations among children with TB were bronchopneumonia (45162), miliary TB (30162) and tuberculous lymphadenopathy (2133). There were no significant differences in clinical presentation of TB between the HIV-negative and HIV-positive groups. The follow-up of those patients with tuberculosis was poor, with only 65 patients (55%) returning to the clinic for scheduled appointments after discharge. All the 16 patients who died did so within 60 days of discharge from hospital; all of them were seropositive for HIV. There were no deaths among the HIV-negative group. Despite the exclusion of Thioacetazone from the treatment regimen, cutaneous reactions occurring within 8 weeks of commencing treatment were observed in 7 of the 65 (11%) patients, 2 of whom developed fatal Stevens-Johnson syndrome. AH 7 patients were seropositive for HIV-1. Conclusions: The seroprevalence rate of HIV type-1 among children with tuberculosis in Lusaka continues to rise; careful monitoring of anti-TB therapy (even in regimens excluding Thioacetazone) for potentially lethal side effects should be carried out.

  • Human immunodeficiency virus type-1 infection in Zambian children with tuberculosis: changing seroprevalance and evaluation of a Thioacetazone-free regimen.
    Tubercle and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 1994
    Co-Authors: C. Luo, Chifumbe Chintu, Ganapati Bhat, Mario Raviglione, Vinod K. Diwan, Herbert L. Dupont, Alimuddin Zumla
    Abstract:

    This study was conducted at the Department of Paediatrics and Child Health, University Teaching Hospital (UTH), in Lusaka, Zambia. To monitor the seroprevalence of HIV type-1 in children with tuberculosis and to evaluate the response to anti-tuberculosis therapy using a Thioacetazone-free treatment regimen. A prospective cross-sectional study of all consecutive newly diagnosed cases of TB in children from 1 month-15 years of age seen at the University Teaching Hospital (UTH) in Lusaka, Zambia between 1 October 1991 and 31 May 1992. 120 children with a clinical diagnosis of tuberculosis and 167 controls were enrolled in the study. The overall HIV type-1 seroprevalence rate in children with tuberculosis was 55.8% (67/120) compared to 9.6% (16/167) amongst the control group (P < 0.0001: odds ratio = 11.50; 95% CI = 5.99-22.7). Common clinical presentations among children with TB were bronchopneumonia (45/162), miliary TB (30/162) and tuberculous lymphadenopathy (21/33). There were no significant differences in clinical presentation of TB between the HIV-negative and HIV-positive groups. The follow-up of those patients with tuberculosis was poor, with only 65 patients (55%) returning to the clinic for scheduled appointments after discharge. All the 16 patients who died did so within 60 days of discharge from hospital; all of them were seropositive for HIV. There were no deaths among the HIV-negative group. Despite the exclusion of Thioacetazone from the treatment regimen, cutaneous reactions occurring within 8 weeks of commencing treatment were observed in 7 of the 65 (11%) patients, 2 of whom developed fatal Stevens-Johnson syndrome. All 7 patients were seropositive for HIV-1. The seroprevalence rate of HIV type-1 among children with tuberculosis in Lusaka continues to rise; careful monitoring of anti-TB therapy (even in regimens excluding Thioacetazone) for potentially lethal side effects should be carried out.

  • HIV-associated tuberculosis in developing countries: clinical features, diagnosis, and treatment.
    Bulletin of the World Health Organization, 1992
    Co-Authors: Mario Raviglione, J.p. Narain, A. Kochi
    Abstract:

    This article reviews the clinical aspects and diagnosis of HIV-associated tuberculosis in developing countries, and summarizes WHO's recommendations for treatment. According to WHO estimates (early 1992) over 4 million persons worldwide have been infected with HIV and tuberculosis; 95% of them are in the developing countries. Clinical features of HIV-associated pulmonary tuberculosis in adults are frequently atypical, particularly in the late stage of HIV infection, with non-cavitary disease, lower lobe infiltrates, hilar lymphadenopathy and pleural effusion. More typical post-primary tuberculosis with upper lobe infiltrates and cavitations is seen in the earlier stages of HIV infection. Extrapulmonary tuberculosis is reported more frequently, despite the difficulties in diagnosing it. WHO's recent guidelines recommend 6-month short-course chemotherapy with isoniazid, rifampicin, pyrazinamide and ethambutol for patients with HIV-associated tuberculosis. The older 12-month regimen without rifampicin is much less effective. Streptomycin should not be used, because of the risk of transmitting blood-borne pathogens through contaminated needles. Thioacetazone should be abandoned, because of severe adverse reactions observed among HIV-infected patients. The roles of preventive chemotherapy and BCG vaccination for prevention of tuberculosis are also briefly discussed.

Ernesto Jaramillo - One of the best experts on this subject based on the ideXlab platform.

  • Pharmacovigilance and tuberculosis: applying the lessons of Thioacetazone.
    Bulletin of the World Health Organization, 2014
    Co-Authors: Dennis Falzon, Geraldine Hill, Shanthi N. Pal, Wimon Suwankesawong, Ernesto Jaramillo
    Abstract:

    Following its introduction in the late 1940s, Thioacetazone was widely-used as an anti-tuberculosis medicine in the following decades.1 Reports of cutaneous hypersensitivity reactions related to its use emerged in the literature soon after its introduction and by the early 1970s the association between the medicine and the adverse drug reaction was well established.2 Despite the increased recognition of this risk, Thioacetazone remained in use mainly in low-income countries because of its low cost.3

  • Pharmacovigilance and tuberculosis: applying the lessons of
    2014
    Co-Authors: Shanthi N. Pal, Ernesto Jaramillo
    Abstract:

    At that time, HIV infection had already reached epidemic proportions in many African countries. Among children and adults with HIV infection and tuberculosis, high fatality was ob-served in those who developed Stevens-Johnson syndrome or toxic epidermal necrolysis when treated with regimens containing Thioacetazone.

Tall Ruth - One of the best experts on this subject based on the ideXlab platform.

  • A second international co-operative investigation into Thioacetazone side-effects*: 1. The influence of a vitamin and antihistamine supplement
    1
    Co-Authors: Miller A. B., Nunn A. J., Robinson D. K., Ferguson G. C., Fox Wallace, Tall Ruth
    Abstract:

    As part of a large-scale international, co-operative investigation into the side-effects produced by Thioacetazone employed in the treatment of tuberculosis, an evaluation has been made of a supplement incorporating vitamins and an antihistamine as a prophylactic

  • A second international cooperative investigation into Thioacetazone side effects: 2. Frequency and geographical distribution of side effects*
    1
    Co-Authors: Miller A. B., Nunn A. J., Robinson D. K., Fox Wallace, Somasundaram P. R., Tall Ruth
    Abstract:

    As part of a large-scale international cooperative investigation into the side effects of Thioacetazone-containing regimens in the treatment of tuberculosis, an evaluation has been made of the variation in the frequency of side effects between different countries and between different centres in the same country and of the likely reasons for this variation. In 3 countries patients of different racial origin were under observation in the same hospital. Over a 12-week period of treatment there was considerable variation between the countries and centres in the overall frequency of side effects and of those leading to a major departure from prescribed treatment, the variation being similar for the two Thioacetazone-containing regimens and for the streptomycin plus isoniazid control regimen, though at a lower level for the latter. In Malaysia, Singapore, and Trinidad, where different racial groups were under treatment, there was no clear indication that race was an important factor in explaining the differences between countries, except for cutaneous side effects in Trinidad and possibly in Malaysia

E. Declercq - One of the best experts on this subject based on the ideXlab platform.

  • extension of the intensive phase reduces unfavourable outcomes with the 8 month Thioacetazone regimen
    International Journal of Tuberculosis and Lung Disease, 2006
    Co-Authors: A. Van Deun, K. J. M. Aung, M. A. Ali, M. S. Naha, P. K. Das, M A Hossain, M Hamid A Salim, E. Declercq
    Abstract:

    CONTEXTE : Projets de lutte contre la tuberculose de la Fondation Damien au Bangladesh. OBJECTIF : Evaluer l'efficacite d'une prolongation d'un mois de la phase intensive chez les patients a frottis positifs apres 2 mois d'un traitement de 8 mois avec de l'isoniazide et de la thiacetazone en phase de continuation. SCHEMA: Etude prospective de deux cohortes de patients a frottis positifs nouvellement enregistres, avec extension de la phase intensive pour le groupe temoin, mais sans extension pour le groupe d'etude. Culture et tests de sensibilite des echecs et rechutes identifies par frottis, et d'un echantillon aleatoire de nouveaux cas. RESULTATS : Parmi 8230 patients du groupe etudie (86,7% de negativation a 2 mois) et 7206 temoins (83,4% de negativation), les taux d'echecs ou de rechutes identifies par frottis ont ete de 3,0% pour les patients negatifs a 2 mois contre 3,1% pour les patients positifs a 2 mois avec prolongation (non significatif, NS) et 8,2% pour les patients positifs a 2 mois sans prolongation (P < 0,00001). Les taux d'echec et de rechute confirmes par culture ont atteint 1,9% chez les patients a frottis negatifs a 2 mois, pour 1,6% (NS) chez ceux a frottis positifs a 2 mois avec prolongation et 3,7% chez ceux a frottis positifs sans prolongation (P < 0,001). Le risque relatif (RR) lie a la non-prolongation de la phase intensive chez les patients positifs a 2 mois a ete de 2,4 (culture) a 2,7 (frottis). Les memes RR et signification marginale ont ete trouves pour la non-prolongation chez les patients dont les souches etaient totalement sensibles. CONCLUSIONS: La prolongation de la phase intensive diminue de maniere considerable les echecs et les rechutes chez les patients a frottis positifs apres 2 mois d'un regime therapeutique relativement faible. Son efficacite peut varier avec le degre de resistance initiale ainsi qu'avec la puissance du regime therapeutique.

  • Extension of the intensive phase reduces unfavourable outcomes with the 8-month Thioacetazone regimen.
    The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2006
    Co-Authors: A. Van Deun, K. J. M. Aung, M. A. Hamid Salim, M. A. Ali, M. S. Naha, P. K. Das, M A Hossain, E. Declercq
    Abstract:

    Damien Foundation tuberculosis (TB) control projects in Bangladesh. To assess the effectiveness of a 1-month extension of the intensive phase for smear-positives at 2 months of an 8-month regimen with a continuation phase consisting of isoniazid (INH) and Thioacetazone (Th). A prospective study of two cohorts of newly registered smear-positive cases, with extension of the intensive phase for the control cohort, but not for the study cohort. Culture and drug susceptibility testing (DST) of smear-defined failures and relapses and of random samples of new cases. Among 8230 study patients (86.7% 2-month conversion) and 7206 controls (83.4% conversion), smear-defined failure or relapse outcome was 3.0% for 2-month smear-negatives vs. 3.1% for 2-month smear-positives with extension (non-significant, NS), and 8.2% for 2-month smear-positives with no extension (P < 0.00001). Culture-confirmed failure and relapse reached 1.9% in 2-month smear-negatives and 1.6% (NS) in 2-month smear-positives with vs. 3.7% (P < 0.001) in 2-month smear-positives with no extension. The relative risk (RR) of non-extension in 2-month smear-positives was 2.4 (cultures) to 2.7 (smears). The same RR and borderline significance was found for non-extension of patients with pan-susceptible strains. Extension of the intensive phase considerably reduces failures and relapses with a weaker regimen in patients smear-positive at 2 months. Its effectiveness may vary with extent of initial drug resistance vs. power of the regimen.