Electrolyte disruption in drug-resistant tuberculosis: Managing risks for improved treatment outcomes

This editorial sheds light on the critical issue of electrolyte imbalance in drug-resistant tuberculosis (TB), a significant challenge exacerbated by the prolonged and intensive treatment regimens required for multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB strains. The use of second-line drugs, such as fluoroquinolones and aminoglycosides, necessary in these cases, often disrupts electrolyte homeostasis, leading to complications like hypokalemia and hypomagnesaemia. These disturbances can pose serious risks to patients, including cardiac arrhythmias and renal dysfunction. Beyond medication effects, TB itself induces systemic inflammation and metabolic alterations, further complicating electrolyte balance. Effective management necessitates vigilant monitoring of electrolyte levels throughout treatment, coupled with renal function assessments and nutritional support.