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Int J Tuberc Lung Dis ; 13(11): 1405-10, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19861014

ABSTRACT

SETTING: Uzbekistan has had 100% DOTS coverage since 2005; however, the treatment success rate has remained at around 80% for the last 4 years. Surveys from the capital city of Tashkent and from western Uzbekistan have shown high levels of primary multidrug resistance. OBJECTIVE: To assess treatment regimens prescribed for new cases of tuberculosis (TB), including the prescription of additional non-TB drugs, and the cost implications for the patient. DESIGN: We randomly sampled 30 clusters of seven new TB patients. Enrolled patients were interviewed and their medical records were reviewed. RESULTS: In general, the treatment regimens prescribed were correct; doses were high rather than low. Second-line anti-tuberculosis drugs were rarely prescribed. In addition to anti-tuberculosis drugs, patients were prescribed on average seven to eight non-TB drugs. The rationale for prescribing the non-TB drugs was, however, questionable. Patients incurred substantial costs for these drugs, some of which were not without risk. CONCLUSION: Prescriptions of anti-tuberculosis drugs for new TB patients are adequate; however, the practice of prescribing additional non-TB drugs needs to be reconsidered.


Subject(s)
Antitubercular Agents/therapeutic use , Practice Patterns, Physicians' , Tuberculosis/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Antitubercular Agents/economics , Drug Costs , Drug Prescriptions , Drug Therapy, Combination , Drug Utilization , Evidence-Based Medicine , Female , Guideline Adherence , Humans , Male , Middle Aged , Practice Guidelines as Topic , Retrospective Studies , Tuberculosis/diagnosis , Tuberculosis/economics , Tuberculosis/epidemiology , Uzbekistan/epidemiology , Young Adult
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