TY - JOUR T1 - Is it necessary to give tuberculosis treatment daily throughout? JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P2614 AU - Kwok-Chiu Chang AU - Chi-Chiu Leung AU - Shan-Shan Huang AU - Cheuk-Ming Tam Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P2614.abstract N2 - BackgroundAlthough daily initial-phase (IP) treatment can better reduce tuberculosis (TB) relapse risk, the optimal continuation-phase (CP) dosing schedule is debatable.ObjectivesWe compared pulmonary TB relapse risks due to daily and thrice-weekly (TIW) CP treatment among patients given standard 6-month or extended standard regimens with daily IP treatment.MethodsTwo cohorts were assembled, one with treatment started from 1998 to 2000, and the other notified from 2006 to 2008. They were followed for 30 months and 24 months after starting treatment, respectively. All received ≥75% daily treatment in the first 2 months, and ≥75% daily or TIW treatment in the next four. Each relapse case was individually matched by sex against 1-5 controls. Relapse risks were estimated by sampling fractions within respective cohorts, and adjusted odds ratios of relapse (AOR) by conditional logistic regression analysis.ResultsOne cohort involved 48 cases and 126 controls, and the other 26 cases and 103 controls. Relapse risks were 46/6152 (0.7%) and 20/4234 (0.5%) for daily treatment, and 2/543 (0.4%) and 6/1087 (0.6%) for TIW treatment. With no significant heterogeneity by the chi-square test, both cohorts were combined. Simultaneously adjusted for 12 covariates, AOR (95% confidence interval) were 0.9 (0.4-2.4) for TIW treatment, 2.4 (1.1-5.1) for initial cavitation, and 4.9 (1.2-20.1) for culture persistence. With no cavitation, relapse risks were 28/6412 (0.4%) for daily and 4/1000 (0.4%) for TIW schedules. Corresponding risks were 38/3974 (1.0%) and 4/630 (0.6%) with cavitation, and 8/510 (1.6%) and 1/97 (1.0%) with cavitation plus culture persistence.ConclusionsGiven standard daily IP treatment, TIW CP treatment may be adequate. ER -