Adverse Reactions and Clinical Outcomes of First-line Antituberculosis Drugs in Elderly Patients with Tuberculosis

BACKGROUND: The prevalence of tuberculosis (TB) in elderly populations is increasing, primarily due to age-related comorbidities that affect treatment tolerance and clinical outcomes. AIM: This study investigated the incidence and types of adverse drug reactions (ADRs) in aging individuals with active pulmonary TB addressed by first-line anti-TB drugs and to assess their impact on clinical outcomes. METHODS: A retrospective analysis was conducted on 375 elderly individuals with active pulmonary TB. The incidence and types of ADRs to anti-TB drugs were assessed, and quality of life (QOL) was measured using the WHOQOL-BREF scale both pretreatment and posttreatment. Risk factors for ADRs were examined using univariate and multivariate logistic regression analyses. RESULTS: Among the study participants, those with congestive heart failure were more common in the 70-80 age group, while neurological diseases were more prevalent in those over 80 years old. The overall incidence of ADRs increased with age, peaking at 56.76% in individuals aged 80 and older. The most common ADRs included gastrointestinal, neurological, and dermatological reactions. Advanced age, male sex, respiratory failure, and higher rifampicin dosages were identified as significant risk factors for ADRs. Although posttreatment QOL improved across all age groups, the improvement was less pronounced in the oldest group. CONCLUSION: In elderly TB patients, factors, such as age, sex, respiratory failure, and drug dosage, significantly influence the incidence of ADRs. Tailored treatment strategies and enhanced monitoring are essential to optimize treatment outcomes and improve QOL in this vulnerable population.