Adverse drug reactions and risk factors for discontinuation of multidrug-resistant tuberculosis regimens in Gujarat, western India

Background. The predictors for discontinuation of multidrug-resistant tuberculosis (MDR-TB) regimens have not been studied in Gujarat. We aimed to find out the adverse drug reactions ( ADRs) and predictors for discontinuation of MDR-TB regimens. Methods. We conducted this cross-sectional study in Bhavnagar district of Gujarat from September to November 2016 through home visits and personal interviews of 94 patients with MDR-TB. Results. Sixty-nine patients with MDR-TB (73%) reported ADRs. Tingling (42.6%), headache (37.2%), numbness (36.2%), dizziness (34%) and nausea (33%) were the most common ADRs. Of the 94 patients, 7.4% were compelled to think of discontinuing their treatment due to ADRs; 8.5% had discontinued Cat-I/Cat-II regimen in the past; 11.7% had discontinued their MDR-TB regimen in the past; 13.8% had their drug regimen changed due to ADRs and 94.7% had good adherence to their current regimen (took at least 80% of their doses till date). ADRs were the reason for 75% of the patients who discontinued their Cat-I/Cat-II regimen in the past and 64% of the patients who discontinued their MDR-TB regimen in the past. Tobacco chewing, poor adherence and thought of discontinuing an MDR-TB regimen due to ADRs were significant predictors for discontinuation on bivariate analysis. On multiple logistic regression, none of the predictors were significant. Conclusions. The frequency of ADRs among patients with MDR-TB is high. ADRs were the primary reason for discontinuing MDR-TB drugs.