Results of the combined mucoactive drug application in the treatment of patients with MDR/XDR tuberculosis

Abstract

Objective. To evaluate the efficacy of a drug containing 7% NaCl and 0.1% sodium hyaluronate in patients with destructive pulmonary tuberculosis with MDR / XDR MBT with inflammatory changes in the tracheobronchial tree.

Materials and methods. A prospective randomized controlled trial was conducted, which included 69 patients with destructive pulmonary tuberculosis with MDR/XDR MBT and with respiratory complaints and changes in the tracheobronchial tree according to fibrobronchoscopy. All patients underwent a dynamic examination. Questionnaires were processed, and dyspnea index calculated in accordance with mMRC, CAT, FBS; the response to treatment was analyzed using the Likert scale. Patients were randomized into two arms that received individualized antituberculosis treatment according to the sensitivity of the pathogen. Nebulizer inhalations with 7% NaCl solution and 0.1% sodium hyaluronate 5 ml 2 times a day for 10 consecutive days (20 procedures in total for each patient) were additionally prescribed to 30 subjects in the main study arm. In control group, 39 subjects received standard mycolytic treatment. Subjects underwent a dynamic examination: results were evaluated before the course of the mucoactive drug (Ist visit), then at the end of the course, after 10 days (2nd visit) and after 30 days (3rd visit) from the moment of inclusion into the study. The significance of differences (p) was determined at p<0.05.

Results. The authors registered an increase in the efficacy of treatment in this category of patients according to the following criteria: disappearance or decrease of respiratory symptoms (on the 10th day from the start of treatment), early relief of inflammatory changes in the tracheobronchial tree (on the 30th day from the start of treatment in 24 (73.4%) subjects in the main group, and 10 (25.1%) in the control group (RR 3.34; 95% CI 2.78–3.90).