ArticlePloS one2013
Drug-associated adverse events and their relationship with outcomes in patients receiving treatment for extensively drug-resistant tuberculosis in South Africa.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 57 papers, 7 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
57 citing papers in PubMed, 7 syntheses or guidelines pooled it, 111 citations in OpenAlex.
- Efficacy and safety of treatment regimens for drug-resistant tuberculosis in different regions: a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- Variation of adverse drug events in different settings in Africa: a systematic review.European journal of medical research · 2024Pooled it
- Tuberculosis related disability: a systematic review and meta-analysis.BMC medicine · 2021Pooled it
- Pooled it
- Drug-associated adverse events in the treatment of multidrug-resistant tuberculosis: an individual patient data meta-analysis.The Lancet. Respiratory medicine · 2020Pooled it
- Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis.Lancet (London, England) · 2018Pooled it
- Effects of Fluroquinolones in Newly Diagnosed, Sputum-Positive Tuberculosis Therapy: A Systematic Review and Network Meta-Analysis.PloS one · 2015Pooled it
- Trial
- A highly effective and inexpensive standardized treatment of multidrug-resistant tuberculosis: a multicenter prospective study in China.BMC infectious diseases · 2021Trial
- Risk of hearing loss among multidrug-resistant tuberculosis patients according to cumulative aminoglycoside dose.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2020Trial
- DOT or SAT for Rifampicin-resistant tuberculosis? A non-randomized comparison in a high HIV-prevalence setting.PloS one · 2017Trial
- Examining the challenges in sustaining user engagement with a mobile app to enhance multidrug-resistant tuberculosis (MDR-TB) care in Vietnam and its implications for implementing person-centred mHealth interventions.PLOS global public health · 2025Article
- Comorbidities and Treatment Outcomes in Patients Diagnosed with Drug-Resistant Tuberculosis in Rural Eastern Cape Province, South Africa.Diseases (Basel, Switzerland) · 2024Article
- Article
- Modulation of Cystatin F in Human Macrophages Impacts Cathepsin-Driven Killing of Multidrug-ResistantMicroorganisms · 2023Article
- Global prevalence of hepatitis B or hepatitis C infection among patients with tuberculosis disease: systematic review and meta-analysis.EClinicalMedicine · 2023Article
- Prevalence of long-term physical sequelae among patients treated with multi-drug and extensively drug-resistant tuberculosis: a systematic review and meta-analysis.EClinicalMedicine · 2023Article
- Adverse event reporting practices in drug-resistant tuberculosis facilities across South Africa.Southern African journal of infectious diseases · 2023Article
- Article
- Article
Corrections and comments
- Erratum issuedGroubusch, Martin [corrected to Grobusch, Martin P]
Authors and funding
16 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTreatment-related outcomes in patients with extensively drug-resistant tuberculosis (XDR-TB) are poor. However, data about the type, frequency and severity of presumed drug-associated adverse events (AEs) and their association with treatment-related outcomes in patients with XDR-TB are scarce.
methodsCase records of 115 South-African XDR-TB patients were retrospectively reviewed by a trained researcher. AEs were estimated and graded according to severity [grade 0 = none; grade 1-2 = mild to moderate; and grade 3-5 = severe (drug stopped, life-threatening or death)].
findings161 AEs were experienced by 67/115(58%) patients: 23/67(34%) required modification of treatment, the offending drug was discontinued in 19/67(28%), reactions were life-threatening in 2/67(3.0%), and 6/67(9.0%) died. ∼50% of the patients were still on treatment at the time of data capture. Sputum culture-conversion was less likely in those with severe (grade 3-5) vs. grade 0-2 AEs [2/27(7%) vs. 24/88(27%); p = 0.02]. The type, frequency and severity of AEs was similar in HIV-infected and uninfected patients. Capreomycin, which was empirically administered in most cases, was withdrawn in 14/104(14%) patients, implicated in (14/34) 41% of the total drug withdrawals, and was associated with all 6 deaths in the severe AE group (renal failure in five patients and hypokalemia in one patient).
conclusionDrug-associated AEs occur commonly with XDR-TB treatment, are often severe, frequently interrupt therapy, and negatively impact on culture conversion outcomes. These preliminary data inform on the need for standardised strategies (including pre-treatment counselling, early detection, monitoring, and follow-up) and less toxic drugs to optimally manage patients with XDR-TB.
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