Fixed-dose combination antituberculosis therapy as a risk factor for tuberculosis recurrence: an evidence-based case report
Abstract: a patient with a
history of tuberculosis (TB) has a risk up to 27% to develop recurrence within
2 years after being cured. Indonesia itself has more than 7,500 recurrent cases
annually, regardless of reinfection or relapse. This is an important problem,
as recurrent TB is associated with lower cure rates with the anti-TB therapy
and higher risk of developing drug resistance. Some risk factors for this
recurrence are smoking, poor treatment adherence, low economic status, and weak
immune status. This study is aimed to identify whether the use of fixed-dose
combination (FDC) anti-tuberculosis therapy increases the risk for tuberculosis
recurrence compared with using separate drug formulation. Methods: the search
was conducted on MEDLINE, ProQuest, EBSCO, ScienceDirect, and Cochrane
according to clinical question. The studies were selected based on inclusion
and exclusion criteria and led to five useful articles. The selected studies
were critically appraised for their validity, importance, and applicability.
Results: five cohort studies were found with comparable validity. Only 1 study
has accurate relative risk (RR) with 3.97 (1.14 – 13.80) and number needed to
harm of 18. Other four studies fulfilled the applicability criteria for our
case. Conclusion: the use of FDC anti-tuberculosis therapy increases the risk
for tuberculosis recurrence compared with using separate drug formulation.
Keywords: tuberculosis;
fixed-dose combination; recurrent
Author: Arvin Pramudita,
Cleopas M Rumende, Ardi Findyartini
Journal Code: jpkedokterangg170338
