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Clinical pharmacy and clinical trials (including case series)
Situation of infection by M. Tuberculosis in a spanish tertiary care hospital
  1. V. Saavedra,
  2. C. Folguera,
  3. M.A. Motos,
  4. A. Torralba
  1. 1University Hospital Puerta De Hierro Majadahonda Pharmacy Madrid, Spain

Abstract

Background Nowadays tuberculosis continues to be a global public health problem. In 2009, 6,131 cases of respiratory tuberculosis were notified in Spain, making it the 8th European country with the highest number of cases notified.

Purpose To analyse the use of tuberculostatic drugs on patients admitted and diagnosed with tuberculosis in a Spanish tertiary care hospital.

Materials and methods A retrospective observational study was carried out for which The authors located patients admitted in the period from September 2010 to September 2011 diagnosed with infection by M. tuberculosis, undergoing treatment with any of the drugs in the following therapeutic groups: J04AB, J04AC, J04AK and J04AM. The authors created a data gathering sheet which included demographic data (sex, age, country of origin) as well as information regarding the treatment received, taking into consideration resistances, intolerances and adherence to the treatment.

Results The authors located 33 patients (68% men) admitted and diagnosed with tuberculosis, of which 14 (42%) were not of Spanish nationality (8 Rumanians, 2 Moroccans, 1 Congolese, 1 Colombian, 1 Bolivian and 1 Peruvian). All the Spanish patients received the first-choice treatment indicated: rifampicin, isoniazid, pyrazinamide and ethambutol, while out of the patients of other nationalities, 12 were found to have first-choice treatment, of which 2 also received amikacin and/or levofloxacin as second-choice drugs used on patients with high suspicion of multi-resistant infection. Another 2 patients showed confirmed multi-resistant infection after various failed treatments carried out over the last few years, and therefore, second-choice drugs had to be used, including ethionamide, cycloserine, p-aminosalycilic acid and ofloxacin.

Conclusions The results obtained confirm the trend observed in the last few years in the most industrialised countries, with a notable increase in the number of cases of tuberculosis among immigrants. Furthermore, in these cases a greater rate of resistances of mycobacterium to traditional drugs has been observed, which complicates therapeutic handling and makes the use of 2nd-choice drugs essential.

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