Patient Adherence and Relapse Rate for the intermittent chemotherapy compared to the daily regimen

Abstract

The aim of this study is to assist clinicians and other healthcare providers in making evidence-based decisions about appropriate treatment of pulmonary tuberculosis, specifically by evaluating the efficacy of intermittent TB chemotherapy compared with the daily short course regimen in regards to: Adherence to treatment and Relapse rate. Prospective comparative, randomized clinical trial, hospital based study is carried out at Kosti teaching hospital using Directly Observed Treatment short course (DOTS), to evaluate the efficacy of intermittent chemotherapy compared to the currently adopted short course therapy. A total of 275 smear positive new cases of Tuberculosis were enrolled and randomized in to two groups, intermittent group (A)(2\ERIZ\ 4\RI) and daily regimen group (B)( 2\SRIZ\ 4\RI) . The raw data were introduced into SPSS program, data comparison was carried out by Pearson Chi square and pair independent sample student T-test. The level of significant was (P<0.05). By the end of the fourth, fifth and the sixth month, no patient was with positive sputum in the two groups. By the end of the second month, haemoptysis was completely disappeared in the two groups. Treatment outcome revealed that the cure rate was higher in group A (55 %) than group B (45.5%); default rate was lower in group A (40.6%) than group B (51%). The percentage of death rate was comparable in group A 0.8% and 0.7% in group B . Significant decrease in the means of ESR at 6 month compared to the initial results. No relapse case detected in the two groups. Intermittent regimen appears to have an advantage over the daily regimen when the financial issue and patient satisfaction are considered. Ultimately the intermittent regimen reduces about 43 % of the cost of drugs consumed in the continuation phase of treatment.