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Management of Hepato-toxicity During treatment with MDR/RR-TB Regimen
Learning Objectives- Identify the risk factors associated with hepatotoxicity during treatment with shorter or longer oral multidrug-resistant tuberculosis (MDR-TB) regimens.
- Learn to recognize the signs and symptoms of hepatotoxicity in patients undergoing MDR-TB treatment.
- Develop proficiency in managing hepatotoxicity reactions, including dose adjustments, temporary cessation of offending medications, or alternative regimen selection.
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The management of hepatotoxicity during treatment with a shorter/ longer oral MDR-TB regimen is elaborated in the figure below. Careful monitoring of Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) levels is important to delineate the line of management.
Figure: Management of Hepatotoxicity During Treatment with Shorter/ Longer Oral MDR-TB Regimen; Source: Guidelines for PMDT, India, 2021, p89.
Resources
- Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021.
- WHO Consolidated Guidelines on Tuberculosis: Module 4 - Treatment: Drug-resistant TB Treatment, 2020.
- Technical and Operational Guidelines for TB in India, 2016.
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