Original Articles
Effectiveness and Tolerance of Antituberculosis Treatment Regimens Without Isoniazid and Rifampicin: Analysis of 85 Cases
José R. Tosta,b, Rafael Vidalc,
, José Maldonadod, Joan A. Caylàe
Corresponding author
ravidal@vhebron.net
Correspondence: Dr R. Vidal Servicio de Neumología, Hospital Universitario Vall d'Hebron Pg. Vall d'Hebron, 119-129 08035 Barcelona, Spain
Correspondence: Dr R. Vidal Servicio de Neumología, Hospital Universitario Vall d'Hebron Pg. Vall d'Hebron, 119-129 08035 Barcelona, Spain
a Servicio de Urgencias, Hospital de Terrassa, Terrassa, Barcelona, Spain
b Servicio de Neumología, CIBERES, Hospital Universitario Vall d'Hebron, Barcelona, Spain
c Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, Spain
d Serveis Clínics, Barcelona, Spain
e Agència de Salut Pública de Barcelona, Barcelona, Spain
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Tost, Rafael Vidal, José Maldonado, Joan A. Caylà" "autores" => array:4 [ 0 => array:3 [ "nombre" => "José R." "apellidos" => "Tost" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 1 => array:4 [ "nombre" => "Rafael" "apellidos" => "Vidal" "email" => array:1 [ 0 => "ravidal@vhebron.net" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 2 => array:3 [ "nombre" => "José" "apellidos" => "Maldonado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] ] 3 => array:3 [ "nombre" => "Joan A." 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Vidal Servicio de Neumología, Hospital Universitario Vall d'Hebron Pg. Vall d'Hebron, 119-129 08035 Barcelona, Spain" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-07-08" "fechaAceptado" => "2008-01-29" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155395" "palabras" => array:5 [ 0 => "Antituberculosis drugs" 1 => "Tuberculosis" 2 => "Drug resistance" 3 => "Drug toxicity" 4 => "Mycobacterium tuberculosis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155396" "palabras" => array:5 [ 0 => "Fármacos antituberculosos" 1 => "Tuberculosis" 2 => "Resistencia a fármacos" 3 => "Toxicidad farmacológica" 4 => "Mycobacterium tuberculosis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To determine if isoniazid-and/or rifampicin-free antituberculosis treatment regimens are safe and effective and to identify any factors that might require changes in the regimens.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">We carried out a retrospective study of patients treated with isoniazid-and/or rifampicin-free regimens between 1995 and 2005 at 2 specialized hospitals in Barcelona, Spain. Predictive factors were studied by logistic regression and the odds ratio; 95% confidence intervals were calculated.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Eighty-five patients were included in the study: 35% were immigrants and 34% were infected with human immunodeficiency virus. The reason for omitting isoniazid or rifampicin was toxicity (53%), followed by multidrug resistance (39%). Rifampicin-free regimens were most common (42%). A change in the isoniazid-and/or rifampicin-free regimen was required in 30% of cases, but was not associated with being an immigrant. The rate of toxicity with these regimens was higher (36%), although progress was always satisfactory. Clinical course was satisfactory in 77% of patients and they were discharged.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Isoniazid-and/or rifampicin-free regimens with adequate follow-up showed similar treatment outcomes compared with standardized treatment regimens. Although these regimens were more toxic, patient progress was good.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Determinar si las pautas de tratamiento antituberculoso sin isoniacida y/o rifampicina (PsHR) son efectivas y seguras, y conocer los factores que obligan a cambiarlas.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio retrospectivo de los pacientes tratados con PsHR entre 1995 y 2005 en 2 centros especializados de Barcelona. Los factores predictores se estudiaron mediante regresión logística, calculándose las <span class="elsevierStyleItalic">odds ratio</span> y sus intervalos de confianza del 95%.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluyó en el estudio a 85 pacientes. Un 35% eran inmigrantes y un 34% estaban infectados por el virus de la inmunodeficiencia humana. La causa de no administrar isoniacida y/o rifampicina fue sobre todo la toxicidad (53%), seguida de resistencia a fármacos antituberculosos (39%). Las pautas sin rifampicina fueron las más frecuentes (42%). Fue preciso cambiar la PsHR en el 30% de los casos y esto se asoció a no ser inmigrante. La toxicidad de las pautas fue más elevada (36%), aunque su evolución fue siempre favorable. El 77% de los pacientes tuvo una evolución satisfactoria y fue dado de alta.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Las PsHR, con un buen seguimiento, poseen una efectividad similar a las pautas estándar y, aunque su toxicidad es más elevada, ésta sigue una evolución correcta.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">This study was funded in part by a grant from the Catalan Society de Pneumology (SOCAP) in 2006 for the Development of Pulmonology Research.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:25 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Whither short-course chemotherapy?" 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 4 | 9 |
| 2024 October | 27 | 15 | 42 |
| 2024 September | 18 | 11 | 29 |
| 2024 August | 34 | 28 | 62 |
| 2024 July | 22 | 21 | 43 |
| 2024 June | 33 | 29 | 62 |
| 2024 May | 48 | 38 | 86 |
| 2024 April | 21 | 21 | 42 |
| 2024 March | 18 | 15 | 33 |
| 2024 February | 24 | 17 | 41 |
| 2023 March | 5 | 3 | 8 |
| 2023 February | 19 | 24 | 43 |
| 2023 January | 16 | 25 | 41 |
| 2022 December | 23 | 36 | 59 |
| 2022 November | 21 | 28 | 49 |
| 2022 October | 22 | 23 | 45 |
| 2022 September | 13 | 23 | 36 |
| 2022 August | 23 | 41 | 64 |
| 2022 July | 22 | 49 | 71 |
| 2022 June | 17 | 33 | 50 |
| 2022 May | 18 | 24 | 42 |
| 2022 April | 14 | 30 | 44 |
| 2022 March | 13 | 32 | 45 |
| 2022 February | 14 | 28 | 42 |
| 2022 January | 14 | 34 | 48 |
| 2021 December | 18 | 52 | 70 |
| 2021 November | 22 | 47 | 69 |
| 2021 October | 24 | 58 | 82 |
| 2021 September | 18 | 62 | 80 |
| 2021 August | 13 | 30 | 43 |
| 2021 July | 8 | 28 | 36 |
| 2021 June | 11 | 34 | 45 |
| 2021 May | 16 | 30 | 46 |
| 2021 April | 38 | 43 | 81 |
| 2021 March | 36 | 30 | 66 |
| 2021 February | 17 | 26 | 43 |
| 2021 January | 7 | 10 | 17 |
| 2020 December | 10 | 19 | 29 |
| 2020 November | 9 | 13 | 22 |
| 2020 October | 5 | 6 | 11 |
| 2020 September | 8 | 3 | 11 |
| 2020 August | 16 | 18 | 34 |
| 2020 July | 8 | 18 | 26 |
| 2020 June | 7 | 4 | 11 |
| 2020 May | 13 | 18 | 31 |
| 2020 April | 14 | 23 | 37 |
| 2020 March | 9 | 9 | 18 |
| 2020 February | 12 | 27 | 39 |
| 2020 January | 14 | 18 | 32 |
| 2019 December | 11 | 12 | 23 |
| 2019 November | 16 | 12 | 28 |
| 2019 October | 10 | 8 | 18 |
| 2019 September | 9 | 15 | 24 |
| 2019 August | 13 | 15 | 28 |
| 2019 July | 7 | 14 | 21 |
| 2019 June | 11 | 11 | 22 |
| 2019 May | 19 | 18 | 37 |
| 2019 April | 23 | 29 | 52 |
| 2019 March | 13 | 21 | 34 |
| 2019 February | 10 | 12 | 22 |
| 2019 January | 2 | 9 | 11 |
| 2018 December | 7 | 10 | 17 |
| 2018 November | 11 | 10 | 21 |
| 2018 October | 8 | 18 | 26 |
| 2018 September | 13 | 9 | 22 |
| 2018 May | 2 | 1 | 3 |
| 2018 April | 16 | 5 | 21 |
| 2018 March | 4 | 5 | 9 |
| 2018 February | 5 | 8 | 13 |
| 2018 January | 4 | 2 | 6 |
| 2017 December | 3 | 6 | 9 |
| 2017 November | 2 | 6 | 8 |
| 2017 October | 3 | 9 | 12 |
| 2017 September | 3 | 5 | 8 |
| 2017 August | 7 | 23 | 30 |
| 2017 July | 10 | 5 | 15 |
| 2017 June | 4 | 6 | 10 |
| 2017 May | 5 | 9 | 14 |
| 2017 April | 3 | 3 | 6 |
| 2017 March | 7 | 10 | 17 |
| 2017 February | 3 | 4 | 7 |
| 2017 January | 3 | 5 | 8 |
| 2016 December | 11 | 6 | 17 |
| 2016 November | 13 | 20 | 33 |
| 2016 October | 15 | 13 | 28 |
| 2016 September | 12 | 7 | 19 |
| 2016 August | 17 | 6 | 23 |
| 2016 July | 13 | 4 | 17 |
| 2016 March | 1 | 0 | 1 |
| 2015 December | 3 | 0 | 3 |
| 2015 October | 76 | 14 | 90 |
| 2015 September | 77 | 11 | 88 |
| 2015 August | 59 | 8 | 67 |
| 2015 July | 67 | 9 | 76 |
| 2015 June | 41 | 7 | 48 |
| 2015 May | 86 | 14 | 100 |
| 2015 April | 59 | 15 | 74 |
| 2015 March | 59 | 11 | 70 |
| 2015 February | 51 | 4 | 55 |
| 2015 January | 47 | 9 | 56 |
| 2014 December | 69 | 7 | 76 |
| 2014 November | 67 | 4 | 71 |
| 2014 October | 82 | 12 | 94 |
| 2014 September | 71 | 7 | 78 |
| 2014 August | 68 | 8 | 76 |
| 2014 July | 55 | 6 | 61 |
| 2014 June | 71 | 6 | 77 |
| 2014 May | 68 | 11 | 79 |
| 2014 April | 82 | 2 | 84 |
| 2014 March | 84 | 7 | 91 |
| 2014 February | 55 | 10 | 65 |
| 2014 January | 42 | 9 | 51 |
| 2013 December | 53 | 10 | 63 |
| 2013 November | 36 | 8 | 44 |
| 2013 October | 52 | 8 | 60 |
| 2013 September | 41 | 8 | 49 |
| 2013 August | 36 | 9 | 45 |
| 2013 July | 53 | 10 | 63 |
| 2013 June | 38 | 8 | 46 |
| 2013 May | 45 | 9 | 54 |
| 2013 April | 34 | 9 | 43 |
| 2013 March | 10 | 1 | 11 |
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