COMPARING THE EFFECTIVENESS OF FIXED-DOSE COMBINATIONS AND SEPARATE-TABLET REGIMENS ON 2-MONTH PULMONARY TUBERCULOSIS SPUTUM CONVERSION
Ichsan Fauzi Triyoga1, Mira Yuliarti2
1Program Studi Profesi Dokter, Fakultas Kedokteran Universitas Indonesia
2Divisi Pulmonologi, Departemen Gastroenterohepatobilier, Rumah Sakit Umum Pusat Nasional Cipto
Mangunkusumo, Fakultas Kedokteran Universitas Indonesia

ABSTRACT

Background: Tuberculosis (TB) is one of the leading causes of death amongst other non-communicable diseases, accounting for up to 845 thousand cases in 2020 in Indonesia alone. Currently, the WHO recommends the use of anti-tuberculosis fixed dose combinations (FDCs) for treating lung TB. However, before the existence of FDCs, patients rely on the use of anti-TB separate tablets (STs). Both forms offer excellent effectiveness and could be measured objectively through bacterial smear conversion, but different dosages and compliance in each individual may alter the outcomes they offer.
Methods: 5 online databases (Cochrane Central Registers of Trials, Cochrane Database of Systematic Review, Embase Classics, MEDLINE(R) ALL, and Pubmed) were used in finding potential studies. Studies were appraised using the Oxford Center for Evidence-Based Medicine (CEBM) Tool, specifically in the validity, importance, and applicability of the studies.
Result: 24 articles were acquired from literature search, and 3 randomized controlled trials (RCTs) were reviewed. All studies found statistically insignificant results between FDCs and STs in 2-month sputum smear conversion. The negative percentage of patients with a negative 2-month sputum conversion result using FDCs ranges from 88% - 96% and those using STs ranges from 89% - 96%. Relative risk results for all studies are within the 95% CI range, hence precision of results are more certain.
Conclusion: In conclusion, all studies reported FDCs nor STs to have significant effectiveness difference in 2-month sputum smear conversion rate. Future studies should consider doing individual analysis of these forms of anti-TB treatment on bacterial smear conversion with factors that could influence conversion time.
Keywords: fixed dose combinations, separate tablets, 2-month sputum smear conversion, lung tuberculosis