Avoidance and management of adverse reactions to antituberculosis drugs

Potent antibiotics are required to cure tuberculosis and reduce the burden of illness in the community. Minor adverse effects are commonly encountered and can be managed by reassurance and explanation. Significant hypersensitivity reactions require cessation of all antituberculosis drugs. Adverse effects should be treated appropriately. An effective antituberculosis regimen should be reestablished as soon as possible. Desensitisation may be necessary if suitable alternative drugs cannot be used. In the event of drug-induced hepatitis, all hepatotoxic drugs should be ceased until symptoms resolve and liver function tests return to normal. Other significant direct toxic effects should be promptly detected and appropriately treated. A thorough knowledge of potential adverse reactions and pharmacokinetics is essential for any physician using antituberculosis drugs.