Anti-tuberculosis drug treatment and adverse reactions in 546 children with tuberculosis in Chongqing, China: A 10-year retrospective study.

BackgroundLong-term combination anti-tuberculosis regimens may lead to various types and severities of adverse drug reactions, potentially resulting in treatment discontinuation, interruption, or prolonged therapy.AimConsidering the lengthy duration of anti-tuberculosis combination regimens, it is crucial to monitor adverse drug reactions occurring during such treatment. This is the first hospital-based study conducted in western China to report adverse drug reactions and assess their prevalence and impact among children with tuberculosis receiving first-line anti-tuberculosis therapy.MethodsA retrospective study was conducted on registered tuberculosis cases at the Children's Hospital of Chongqing Medical University from 2014 to 2023. Data on demographic characteristics, treatment regimens, and adverse drug reactions were collected and evaluated. Statistical methods were used to analyze factors associated with adverse drug reactions.ResultsAmong 546 patients receiving anti-tuberculosis therapy, adverse drug reactions were reported in 476 (87.18%). Hyperuricemia was the most common adverse drug reaction (44.26%), followed by elevated liver enzymes without jaundice and elevated bile acids (10.38%) and leukopenia (8.31%). Most adverse drug reactions occurred within the first month of treatment (51.48%), whereas 33.44% persisted for >6 months. Pyrazinamide was the most frequently suspected causative drug (7.47%). Univariate analysis showed significantly higher adverse drug reaction rates among children aged 11-18 years, those with severe tuberculosis, those receiving the isoniazid + rifampicin + pyrazinamide + ethambutol + linezolid regimen, those on a recommended dose of rifampicin, and those receiving a high dose of pyrazinamide (p < 0.05). Logistic regression identified age (odds ratio = 1.640, 95% confidence interval: 1.127-2.388, p = 0.010) and the isoniazid + rifampicin + pyrazinamide + ethambutol + levofloxacin regimen (odds ratio = 0.210, 95% confidence interval: 0.048-0.932, p = 0.040) as factors that reduced the odds of adverse drug reactions.ConclusionsA high occurrence rate of adverse drug reactions was observed in children undergoing anti-tuberculosis treatment. Timely recognition and management of adverse drug reactions is essential in this patient population.