Research Article
Comparison of Serum Potassium, MagnEsium, and Calcium
Levels between Kanamycin and Capreomycin-BASEd
Regimen-Treated MultiDrug-Resistant TuBerculosis Patients in
Bandung (CEASE MDR-TB): A Retrospective Cohort Study
ArtoYuwonoSoeroto,
1,2
GunturDarmawan ,
2
RudiSupriyadi,
2,3
PanjiGugahBhaskara,
2
Prayudi Santoso,
1,2
Bachti Alisjahbana,
2,4
and Ida Parwati
5
1
Respirology and Critical Illness Division, Internal Medicine Department, Hasan Sadikin General Hospital/Faculty of Medicine,
Universitas Padjadjaran, Bandung, Indonesia
2
Internal Medicine Department, Hasan Sadikin General Hospital/Faculty of Medicine, Universitas Padjadjaran, Bandung,
Indonesia
3
Nephrology and Hypertension Division, Internal Medicine Department, Hasan Sadikin General Hospital/Faculty of Medicine,
Universitas Padjadjaran, Bandung, Indonesia
4
Tropical and InfectiousDisease Division, Internal Medicine Department, Hasan Sadikin General Hospital/Faculty of Medicine,
Universitas Padjadjaran, Bandung, Indonesia
5
Clinical Pathology Department, Hasan Sadikin General Hospital/Faculty of Medicine, Universitas Padjadjaran, Bandung,
Indonesia
Correspondence should be addressed to Guntur Darmawan; guntur_d@yahoo.com
Received 1 November 2018; Revised 30 January 2019; Accepted 26 February 2019; Published 14 March 2019
Academic Editor: Todd R. Callaway
Copyright © 2019 Arto Yuwono Soeroto et al. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Treatment of multidrug-resistant tuberculosis (MDR-TB) with second-line injectable drugs may result in an electrolyte
imbalance. is retrospective study was performed to compare and evaluate the effect of kanamycin and capreomycin on serum
potassium, calcium, and magnesium in the first and second month treatment at a tertiary, top-referral hospital in Bandung,
Indonesia. Data from 84 subjects with complete medical records of at least serum potassium during either kanamycin-based or
capreomycin-based treatment were retrieved from the institutional database. Among these, 53 subjects had complete serum
calcium data and 53 subjects had complete serum magnesium data. After the first month of MDR-TB treatment, there was a
significant decrease in mean serum potassium (4.0 ± 0.4 mEq/L to 3.7 ± 0.5mEq/L, p < 0.003) in the kanamycin-based group
and (4.1 ± 0.5 mEq/L to 3.2 ± 0.6mEq/L, p < 0.001) in the capreomycin-based group. Serum potassium levels were significantly
lower in the capreomycin-based group than in the kanamycin-based group (3.2 ± 0.6 mEq/L vs 3.7 ± 0.5mEq/L, p < 0.001). e
incidence of hospitalization and requirement for a change in the treatment regimen due to electrolyte imbalances were higher
in the capreomycin-based group. No previous longitudinal study has evaluated serum potassium, magnesium, and calcium
from the first month of MDR-TB treatment with either kanamycin-based or capreomycin-based regimens. Our findings
emphasize the importance of routine monitoring of serum potassium, magnesium, and calcium during MDR-TB treatment,
and that more attention should be paid when treatment is given using the capreomycin-based regimen. Moreover, our study
supported the 2018 World Health Organization treatment guideline recommendations for removal of kanamycin and
capreomycin from the MDR-TB regimens.
Hindawi
International Journal of Microbiology
Volume 2019, Article ID 5065847, 7 pages
https://doi.org/10.1155/2019/5065847