The Analysis of Adverse Effects of Pyrazinamide in the Therapy of Pulmonary Tuberculosis in the Elderly and Its Effect on Serum IFN‐γ and TNF‐α Levels

Objective To evaluate the therapeutic efficacy and safety of pyrazinamide compared with pasiniazid in elderly patients with pulmonary tuberculosis (PTB) and to investigate their effects on serum inflammatory markers, including interferon‐gamma (IFN‐γ) and tumor necrosis factor‐alpha (TNF‐α). Methods Clinical data of 82 elderly PTB patients admitted between December 2022 and December 2023 were retrospectively analyzed. According to their documented treatment regimens, patients were divided into a control group ( n = 41, treated with pasiniazid) and a study group ( n = 41, treated with pyrazinamide). Sputum conversion rate, radiological lesion improvement, incidence of adverse drug reactions, and serum IFN‐γ and TNF‐α levels were compared between the two groups. Results After 3 and 6 months of therapy, sputum conversion rates in the pyrazinamide group were 85.37% and 95.12%, respectively, significantly higher than those in the pasiniazid group (63.41% and 80.49%, P < 0.05). The total improvement efficiency was 90.24% in the study group versus 70.73% in the control group ( P < 0.05). The incidence of adverse reactions was lower in the pyrazinamide group (14.63%) compared with the control group (36.59%, P < 0.05). After 3 months of treatment, both TNF‐α and IFN‐γ levels were markedly reduced in both groups ( P < 0.05), with greater decreases observed in the pyrazinamide group ( P < 0.001), suggesting enhanced immunomodulatory effects and better inflammatory resolution. Conclusion Pyrazinamide demonstrates superior therapeutic efficacy and lower adverse reaction rates compared with pasiniazid in elderly PTB patients. Its use is associated with significant reductions in systemic inflammatory cytokines (TNF‐α and IFN‐γ), indicating potential immunomodulatory benefits and clinical value as an adjunctive agent in tuberculosis management.