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  • Incidence and risk factors for drug intolerance and association with incomplete treatment for tuberculosis: analysis of national case registers for England, Wales and Northern Ireland, 2001–2010

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Chest clinic
Audit, research and guideline update
Incidence and risk factors for drug intolerance and association with incomplete treatment for tuberculosis: analysis of national case registers for England, Wales and Northern Ireland, 2001–2010
  1. Catherine Smith1,2,
  2. Ibrahim Abubakar2,3,4,
  3. H Lucy Thomas3,
  4. Laura Anderson3,
  5. Marc Lipman5,6,
  6. Mark Reacher1
  1. 1Field Epidemiology Services – Cambridge, Public Health England, UK
  2. 2Department of Infection and Population Health, Centre for Infectious Disease Epidemiology, University College London, London, UK
  3. 3Respiratory Diseases Department, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
  4. 4MRC Clinical Trials Unit, University College London, London, UK
  5. 5Respiratory Medicine, Royal Free London NHS Foundation Trust, London, UK
  6. 6Division of Medicine, University College London, London, UK
  1. Correspondence to Mark Reacher, Field Epidemiology Services, Public Health England, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 0SR, UK; mark.reacher{at}phe.gov.uk

Abstract

Anti-tuberculosis drug regimens are efficacious, but drug intolerance can be severe and may impact on treatment completion rates. The Enhanced Tuberculosis Surveillance (ETS) system is a case register of all new notifications of tuberculosis in England, Wales and Northern Ireland. We conducted a cohort study to estimate the incidence of, and risk factors for, drug intolerance reported through ETS between 2001 and 2010 and to assess its relationship with treatment non-completion. Reports of drug intolerance were found for 868/67 547 (1.28%) patients in the cohort, and important risk factors were female sex, older age, later case report year and white ethnicity. Drug intolerance was associated with an approximate fivefold increased odds of treatment non-completion (p<0.001). These results highlight the need for better-tolerated drug regimens and close case management of patients at risk of drug intolerance to improve treatment completion rates and contribute to more effective disease control.

  • Tuberculosis

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https://doi.org/10.1136/thoraxjnl-2013-204503

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