Evaluating the effectiveness of first-Line anti-tuberculosis in Al Dhafra Hospitals
Abstract
Background: Tuberculosis (TB) continues to be a significant public health issue despite extensive efforts to control it. The standard treatment for TB involves the use of first-line anti-TB drugs administered at a standard dose. However, the effectiveness of this treatment can vary between individual patients, resulting in differing cure rates.
Methodology: The objective of this retrospective study was to assess the effectiveness and safety of first-line generic anti-TB medications administered at Liwa Hospital in the Al Dhafra Region. Data was collected from the electronic medical records of 140 TB patients admitted to Liwa Hospital from January to December 2022. The study included patients with positive acid-fast bacillus (AFB) or polymerase chain reaction (PCR) test results, indicating active TB infection. Patients resistant to first-line anti-TB medications or with lung cancer were excluded. Data collected included demographic information, length of stay conversion time, hospital admission, prescribed medications, treatment duration, and treatment outcomes.
Results: This study observed an average length of stay of 21 days for patients treated with first-line generic anti-TB medications at Liwa Hospital. Over 80% of the patients were discharged within 30 days of admission, indicating a positive response to the medications. Approximately 13% of the patients required a longer duration of treatment and were discharged between 30 and 60 days after admission. Only 5% of the patients had a prolonged stay of over 60 days, most of whom had co-morbidities or rifampicin resistance, but achieved AFB conversion within three months. The average conversion time for patients was 25 days, with over 92% achieving conversion within two months.
Conclusion: This study demonstrated the efficacy and safety of first-line generic anti-TB medications in treating TB patients at Liwa Hospital. The majority of patients responded well to the medications, leading to discharge within 30 days.
Keywords: Tuberculosis, Ethambutol, Pyrazinamide, Rifampicin, Isoniazid, First line drugs, Anti TB drugs
Keywords:
Tuberculosis, Ethambutol, Pyrazinamide, Rifampicin, Isoniazid, First line drugs, Anti TB drugsDOI
https://doi.org/10.22270/jddt.v13i8.5939References
Sileshi, T., Tadesse, E., Makonnen, E., and Aklillu, E. The Impact of First-Line Anti-Tubercular Drugs' Pharmacokinetics on Treatment Outcome: A Systematic Review. Clin Pharmacol. 2021; 13:1-12. https://doi.org/10.2147/CPAA.S289714
Natarajan, A., Beena, P., Devnikar, A.V., and Mali, S. A systemic review on tuberculosis. Indian Journal of Tuberculosis. 2020; 67(3):295-311. https://doi.org/10.1016/j.ijtb.2020.02.005
MacNeil, A., Glaziou, P., Sismanidis, C., Maloney, S., and Floyd, K. Global epidemiology of tuberculosis and progress toward achieving global targets-2017. Morbidity and Mortality Weekly Report. 2019; 68(11):263. https://doi.org/10.15585/mmwr.mm6811a3
World Health Organization (WHO). The End TB strategy. World Health Organization; 2015.
Yoeli, E., Rathauser, J., Bhanot, S.P., Kimenye, M.K., Mailu, E., Masini, E., et al. Digital health support in treatment for tuberculosis. New England Journal of Medicine. 2019; 381(10):986-7. https://doi.org/10.1056/NEJMc1806550
Abdullahi, O.A., Ngari, M.M., Sanga, D., Katana, G., and Willetts, A. Mortality during treatment for tuberculosis; a review of surveillance data in a rural county in Kenya. PLoS One. 2019; 14(7):e0219191. https://doi.org/10.1371/journal.pone.0219191
Chakaya, J., Khan, M., Ntoumi, F., Aklillu, E., Fatima, R., Mwaba, P., et al. Global Tuberculosis Report 2020-Reflections on the Global TB Burden, treatment and prevention efforts. International Journal of Infectious Diseases. 2021; 113:S7-S12. https://doi.org/10.1016/j.ijid.2021.02.107
Gillespie, S.H., Crook, A.M., McHugh, T.D., Mendel, C.M., Meredith, S.K., Murray, S.R., et al. Four-month moxifloxacin-based regimens for drug-sensitive tuberculosis. New England Journal of Medicine. 2014; 371(17):1577-87. https://doi.org/10.1056/NEJMoa1407426
Zaidi, H.A., and Wells, C.D. Digital health technologies and adherence to tuberculosis treatment. Bulletin of the World Health Organization. 2021; 99(5):323. https://doi.org/10.2471/BLT.21.286021
Srivastava, S., Alffenaar, J.W., and Wicha, S.G.. Pharmacology of infectious diseases: world tuberculosis day 2022. Frontiers in Pharmacology. 2023; 14:1233347. https://doi.org/10.3389/fphar.2023.1233347
Gopalaswamy, R., Shanmugam, S., Mondal, R., and Subbian, S. Of tuberculosis and non-tuberculous mycobacterial infections-a comparative analysis of epidemiology, diagnosis, and treatment. Journal of Biomedical Science. 2020; 27(1):1-17. https://doi.org/10.1186/s12929-020-00667-6
World Health Organization (WHO). WHO consolidated guidelines on tuberculosis: tuberculosis preventive treatment. World Health Organization; 2020.
Moore, D.P., Hesseling, A.C., and Marx, F.M. Prolonged-course tuberculosis treatment or secondary prevention for those at high risk of recurrence? Clinical Microbiology and Infection. 2022; 28(5):631-3. https://doi.org/10.1016/j.cmi.2022.01.013
Lan, Z., Ahmad, N., Baghaei, P., Barkane, L., Benedetti, A., Brode, S.K., et al. Drug-associated adverse events in the treatment of multidrug-resistant tuberculosis: an individual patient data meta-analysis. The Lancet Respiratory Medicine. 2020; 8(4):383-94. https://doi.org/10.1016/S2213-2600(20)30047-3
Rodríguez-Castillo, J.A., Arce-Mendoza, A.Y., Quintanilla-Siller, A., Rendon, A., Salinas-Carmona, M.C., and Rosas-Taraco, A.G. Possible association of rare polymorphism in the ABCB1 gene with rifampin and ethambutol drug-resistant tuberculosis. Tuberculosis. 2015; 95(5):532-7. https://doi.org/10.1016/j.tube.2015.04.004
Paton, N.I., Cousins, C., Suresh, C., Burhan, E., Chew, K.L., Dalay, V.B., et al. Treatment strategy for rifampin-susceptible tuberculosis. New England Journal of Medicine. 2023; 388(10):873-87. https://doi.org/10.1056/NEJMoa2212537
Nardotto, G.H.B., Bollela, V.R., Rocha, A., Della Pasqua, O., and Lanchote, V.L. No implication of HIV coinfection on plasma exposure to rifampicin, pyrazinamide, and ethambutol in tuberculosis patients. Clinical and Translational Science. 2022; 15(2):514-23. https://doi.org/10.1111/cts.13169
Modlin, S.J., Mansjö, M., Werngren, J., Ejike, C.M., Hoffner, S.E., and Valafar, F. Pyrazinamide-resistant Tuberculosis Obscured From Common Targeted Molecular Diagnostics. Drug Resistance Updates. 2023; 68:100959. https://doi.org/10.1016/j.drup.2023.100959
Pradipta, I.S., Houtsma, D., van Boven, J.F., Alffenaar, J.-W.C., and Hak, E. Interventions to improve medication adherence in tuberculosis patients: a systematic review of randomized controlled studies. NPJ Primary Care Respiratory Medicine. 2020; 30(1):21. https://doi.org/10.1038/s41533-020-0179-x
Zegeye, A., Dessie, G., Wagnew, F., Gebrie, A., Islam, S.M.S., Tesfaye, B., et al. Prevalence and determinants of anti-tuberculosis treatment non-adherence in Ethiopia: a systematic review and meta-analysis. PloS one. 2019; 14(1):e0210422. https://doi.org/10.1371/journal.pone.0210422
Kurahara, Y., Kobayashi, T., Tachibana, K., and Tsuyuguchi, K.. The feasibility of rifampicin Re-administration in patients with tuberculosis and Clostridioides difficile infection. Journal of Infection and Chemotherapy. 2022; 28(4):558-62. https://doi.org/10.1016/j.jiac.2021.12.031
Requena-Méndez, Ana et al. "Effects of dosage, comorbidities, and food on isoniazid pharmacokinetics in Peruvian tuberculosis patients." Antimicrobial agents and chemotherapy. 2014; 58(12):7164-70. https://doi.org/10.1128/AAC.03258-14
Burhan, Erlina et al. "Isoniazid, rifampin, and pyrazinamide plasma concentrations in relation to treatment response in Indonesian pulmonary tuberculosis patients." Antimicrobial agents and chemotherapy. 2013; 57(8):3614-9. https://doi.org/10.1128/AAC.02468-12
Pasipanodya, J.G., McIlleron, H., Burger, A., Wash, P.A., Smith, P., and Gumbo T. Serum drug concentrations predictive of pulmonary tuberculosis outcomes. The Journal of Infectious Diseases. 2013; 208(9):1464-73. https://doi.org/10.1093/infdis/jit352
Velásquez, G.E., Brooks, M.B., Coit, J.M., Pertinez, H., Vargas Vásquez, D., Sánchez Garavito, E., et al. Efficacy and safety of high-dose rifampin in pulmonary tuberculosis. A randomized controlled trial. American Journal of Respiratory and Critical Care Medicine. 2018; 198(5):657-66. https://doi.org/10.1164/rccm.201712-2524OC
Aarnoutse, R., Kibiki, G., Reither, K., Semvua, H., Haraka, F., Mtabho, C., et al. Pharmacokinetics, tolerability, and bacteriological response of rifampin administered at 600, 900, and 1,200 milligrams daily in patients with pulmonary tuberculosis. Antimicrobial Agents and Chemotherapy. 2017; 61(11):e01054-17. https://doi.org/10.1128/AAC.01054-17
Srivastava, S., and Gumbo, T. Therapeutic drug monitoring and fluoroquinolones for multidrug-resistant tuberculosis. European Respiratory Journal. 2021; 57(4). https://doi.org/10.1183/13993003.04454-2020
Wu, H.-H., Chen, Y.-T., Shih, C.-J., Lee, Y.-T., Kuo, S.-C., and Chen, T.-L. Association between recent use of proton pump inhibitors and nontyphoid salmonellosis: a nested case-control study. Clinical Infectious Diseases. 2014; 59(11):1554-8. https://doi.org/10.1093/cid/ciu628
Published
Abstract Display: 486 
PDF Downloads: 493 PDF Downloads: 24 How to Cite
Issue
Section
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
How to Cite
.