Abstract
A potential threat to success of new tuberculosis (TB) drugs is the development of resistance. Using drugs in appropriate regimens such as recommended in the World Health Organization (WHO) treatment guidelines prevents the development of resistance. A systematic review was performed to assess the prevalence of inappropriate prescription of TB drugs for treatment of TB.
MEDLINE, EMBASE and other databases were searched for relevant articles in January 2011. Observational studies published from 2000 that included TB patients receiving treatment were selected. A treatment regimen was considered inappropriate if the regimen was not a WHO-recommended regimen.
Thirty-seven studies were included. In 67% of the studies inappropriate treatment regimens were prescribed. The percentage patients receiving inappropriate regimens varied between 0.4% and 100%. In 19 studies the quality of treatment regimen-reporting was low.
Despite the fact that assessment of inappropriate treatment was hampered by low quality of reporting, our data indicate a reasonable amount of inappropriate prescription of TB treatment regimens. Thus, there is a risk that new drugs will be used in inappropriate treatment regimens, even with WHO guidelines in place, introducing the risk of resistance development. This review highlights the need to improve implementation of the WHO treatment of tuberculosis guidelines.
- ERS
