ArticleLung India : official organ of Indian Chest Society
Utility of para-aminosalicylic acid in drug-resistant tuberculosis: Should it be classified as Group D3 or Group C?
Article in Lung India : official organ of Indian Chest Society. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 9 citations in OpenAlex.
- MetF-Dependent Methionine Biosynthesis Is Required for Mycobacterium tuberculosis Survival and In Vivo Persistence.MicrobiologyOpen · 2026Article
- Catalase activity deficiency sensitizes multidrug-resistant Mycobacterium tuberculosis to the ATP synthase inhibitor bedaquiline.Nature communications · 2024Article
- The aminosalicylate - folate connection.Drug metabolism reviews · 2024Review
- The clinical presentation and detection of tuberculosis during pregnancy and in the postpartum period in low- and middle-income countries: A systematic review and meta-analysis.PLOS global public health · 2023Article
- The pharmacokinetics of para-aminosalicylic acid and its relationship to efficacy and intolerance.British journal of clinical pharmacology · 2020Review
- Multi-omics comparisons of p-aminosalicylic acid (PAS) resistance in folC mutated and un-mutated Mycobacterium tuberculosis strains.Emerging microbes & infections · 2019Article
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2 authors at 1 institution in 1 country.
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Abstract
backgroundThe World Health Organization drug-resistant tuberculosis (DR-TB) 2016 guidelines reclassified para-aminosalicylic acid (PAS) as Group D3 "add-on" drug. We studied our DR-TB data wherein PAS was widely and preferably used as a substitute in the standardized regimen in varied situations and report its utility in DR-TB. METHODOLOGY: This retrospective observational study enrolled both pulmonary and extrapulmonary DR-TB patients receiving PAS in the programmatic management of DR-TB from March 2012 to June 2013. They were divided into seven subgroups on the basis of indication for PAS substitution in the standardized regimen for DR-TB cases. The clinical profile and outcomes were analyzed.
resultsPAS was substituted in 250 cases (225 - pulmonary DR-TB and 25 - extrapulmonary DR-TB). PAS was used in (1) pre-extensively drug-resistant TB (XDR-TB) fluoroquinolones (FQs) - 136 (54.4%), (2) XDR-TB - 15 (6%), (3) substitute drug for serious adverse events - 3 (1.2%), (4) pregnant DR-TB patients - 5 (2%), (5) patients on successful private-based second-line therapy adopted under the Revised National Tuberculosis Control Program - 10 (4%), (6) substitute drug for previous FQ exposure - 5 (2%), and (7) Category V - 76 (30.4%). Although 51.2% had an unfavorable response (UFR) against 48.8% with FR, wide disparity was noted in subgroups. FR was observed in 68.4% pre-XDR-TB (FQ), 80% pregnant patients, 90% adopted from private on successful second-line therapy, 80% previous FQ exposure against 40% XDR-TB, 7.9% Category V, and 0% PAS substitution for adverse drug reactions (ADRs). UFR was seen in 31.6% pre-XDR-TB (FQ), 20% pregnant patients, 10% adopted from private on successful second-line therapy, 20% of previous FQ exposure against 60% XDR-TB, 92.1% Category V, and 100% on PAS substitution for ADR.
conclusionIn view of the safety and efficacy of PAS in our DR-TB patients except for XDR and Category V group, we recommend larger studies with PAS and consider its reclassification into Group C rather than Group D3.
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