Fixed-dose combination versus separate drug formula for pulmonary and extrapulmonary tuberculosis

• Published in: The Egyptian Journal of Bronchology 2018-07, Vol.12 (3), p.346-351
• Main Authors: El-Kholy, Maha M., Sadek, Samiaa H., Mahran, Osama
• Format: Article
• Language: English
• Subjects: adverse effects; Drug dosages; drugs; effectiveness; Laboratories; Medicine & Public Health; Original Article; Tuberculosis
• ISSN: 1687-8426; 2314-8551
• DOI: 10.4103/ejb.ejb_61_17

Introduction The prescription of an effective and well-tolerated antituberculosis (TB) treatment regimen is an important step in the management of TB. Objective The aim of the present study was comparison between fixed-dose combination (FDC) anti-TB drugs and separate drug formula (SDF) not only in pulmonary tuberculosis (PTB) but also in extrapulmonary tuberculosis (EPTB). Patients and methods A total of 240 patients with TB were included in the present study: 122 patients had PTB and 118 had EPTB. Both patients with PTB and those with EPTB were divided into two groups according to receiving FDC or SDF. All patients had baseline clinical and laboratory data, including blood picture, liver function tests, renal function tests, erythrocyte sedimentation rate, uric acid, and chest radiography. Follow-up clinical, laboratory, and radiology assessments were done during the course of treatment. Patients who received FDC and those who received SDF were compared for clinical, laboratory, radiological improvement, and sputum conversion in PTB during the course of treatment; moreover, they were compared for drug tolerance, compliance with treatment, and development of adverse effects. Results Both FDC and SDF in PTB and EPTB had comparable effect with respect to clinical improvement, and also sputum conversion in PTB; significant change in liver function was observed in PTB among those who received FDC, but better radiological clearance was detected with SDF. Both regimens were comparable with respect to compliance and adverse effects, except for more gastric disturbance with FDC. Conclusion SDF is recommended in patients with borderline liver function, gastrointestinal troubles, and presence of extensive radiological infiltrate.