Latar belakang: Tuberkulosis resistan obat (TB RO) masih merupakan ancaman dalam pengendalian tuberkulosis di dunia termasuk di Indonesia. Salah satu penyebab sulitnya pengendalian TB di Indonesia adalah karena kepatuhan pengobatan, menurut beberapa studi penyebab pasien tidak patuh minum obat adalah karena efek samping yang diderita. Anemiaa merupakan salah satu efek samping yang paling sering terjadi pada pasien TB RO baik karena proses inflamasi maupun karena efek samping obat anti tuberkulosis (OAT), salah satunya penyebab adalah linezolid yang merupakan salah satu “tulang punggung” pengobatan TB RO di Indonesia karena efektivitasnya yang tinggi. Anemiaa memiliki etiologi yang bermacam-macam, salah satunya defisiensi besi yang sering dikaitkan dengan TB baik karena kekurangan atau kelebihan Fe dalam tubuh.Metode: Penelitian merupakan studi kohort prospektif dan dilakukan analisis pada faktor risiko menggunakan total 42 subjek pasien TB-RO yang menjalani pengobatan OAT mengandung linezolid di RSUPRN Persahabatan. Kemudian dilakukan pencatatan karakteristik individu, proporsi kejadian anemia di setiap 2 minggu pengamatan, selisih perubahan kadar Hb dan feritin dilanjutkan dengan peninjauan hubungan karakteristik individu terhadap kejadian anemia.Hasil: Dari total seluruh subjek yang mendapatkan terapi OAT mengandung linezolid terdapat 7 pasien (16,7%) mengalami anemia di minggu ke-2, anemia di minggu ke-4 sebanyak 3 pasien (8,6%), anemia di minggu ke-6 sebanyak 5 pasien (15,6%) dan anemia di minggu ke-8 sebanyak 4 pasien (4,8%). Terdapat penurunan kadar Hb setiap 2 minggu selama pengobatan OAT dengan selisih antara 0,1-0,6 g/dL. Penurunan kadar feritin terjadi berturut-turut mulai minggu ke-4 hingga ke-8 dengan selisih antara 38,95- 69,75 ng/mL. Karakteristik klinis seperti usia, jenis kelamin, indeks massa tubuh dan luas lesi tidak tidak memiliki hubungan yang bermakna secara statistik terhadap kejadian anemia dan perubahan kadar feritin pada pasien TB-RO yang mendapatkan linezolid.Kesimpulan: Terdapat insidens anemia pada pasien TB-RO yang mendapatkan terapi dengan linezolid sebesar 45,7% serta ditemukan perubahan kadar feritin yang fluktutatif selama masa pengamatan 8 minggu. Tidak ada hubungan antara karakteristik individu seperti usia, jenis kelamin, IMT dan luas lesi terhadap kejadian anemia namun terdapat hubungan antara DM tipe 2 dengan perubahan feritin.

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Background: Drug-resistant tuberculosis (DR-TB) is still a threat to tuberculosis control in the world, including in Indonesia. Reason for the difficulty of controlling TB in Indonesia is due to treatment adherence, according to several studies the cause of patients not adhering to taking medication is due to the side effects suffered. Anemiaa is one of the most common side effects in DR-TB patients either due to the inflammatory process or due to side effects of anti-tuberculosis drugs (ATD), one of which is linezolid, which is one of the “backbones” of DR-TB treatment in Indonesia due to its high effectiveness. Anemiaa has various etiologies, one of which is iron deficiency, which is often associated with TB due to either a lack or excess of Fe in the body.

Method: The study was an observational cohort study with a prospective approach and analyzed risk factors using a total of 42 subjects of TB-RO patients undergoing ATD treatment containing linezolid at Friendship Hospital. Then, individual characteristics were recorded, the proportion of anemiac events in every 2 weeks of observation, the difference in changes in Hb and ferritin levels, followed by a review of the relationship between individual characteristics and the incidence of anemiaa.

Results: From the total subjects who received ATD therapy containing linezolid, 7 patients (16.7%) experienced anemiaa in 2nd week, 3 patients (8.6%) in 4th week, 5 patients (15.6%) experienced anemiaa in 6th week and anemiaa in week 8 was 4 patients (4.8%). There was a decrease in Hb levels every 2 weeks during ATD treatment with a difference between 0.1-0.6 g/dL. The decrease in ferritin levels occurred successively from week 4 to 8 with a difference between 38.95-69.75 ng/mL. Clinical characteristics such as age, gender, body mass index and lung field lesion area did not have a statistically significant relationship with the incidence of anemiaa and changes in ferritin levels in patients with DR-TB receiving linezolid.

Conclusion: There was an incidence of anemia in TB-RO patients treated with linezolid of 45.7% and changes in ferritin levels were found to be fluctuating during the 8-week observation period. There was no relationship between individual characteristics such as age, gender, BMI and lesion area on the incidence of anemia, but there is a relationship between type 2 DM and ferritin changes.