Table 5– Inappropriate tuberculosis (TB) treatment regimens in Europe and America#
First author [ref.]CountrySettingPeriod of data collectionSample size nInappropriate TB treatment regimensData quality
SCTR
Richardson [35]USATB control database1995–1998770Authors: of the 770 cases, 28.7% did not receive the CDC/ATS recommended drug regimen (HRZE[S])**
Grupo del Trabajo del PMIT [36]SpainTB register1996–199710053Authors: more than 76% of the subjects were treated in agreement with Spanish guidelines**
Diel [37]GermanyPublic health bureaus register1997–1999515Authors: as the survey shows, preferred tuberculosis treatment in Hamburg was a three-drug regimen (86.7%), with an average duration of about 9 months. This deviates from the WHO recommended standard of a four-drug regimen, and also exceeds the recommended short-term treatment period of 6 months****
Valin [38]FranceTertiary care hospitals, prison and welfare centres2004629Authors: 14% no HRZE in intensive phase¶,+
Duration of TB treatment was not applied as recommended in more than 33% of cases
****
Hasker [39]UzbekistanTB control programme2006180Assessed (from table):
Pulmonary TB, new smear positive: 26%
Pulmonary TB, new smear negative: 4%
New extra-pulmonary TB: 31%
*****
  • SC: study characteristics; TR: treatment regimens; CDC/ATS: Center for Disease Control/American Thoracic Society; H: isoniazid; R: rifampicin; E: ethambutol; Z: pyrazinamide; S: streptomycin; WHO: World Health Organization. *: low quality; **: moderate quality; ***: high quality. #: general population including children; : for patients that did receive HRZE but were smear negative or had less severe extra-pulmonary TB, HRZE is over treatment and therefore not appropriate; +: non-HRZE regimens not specified, these regimens might be appropriate for smear negatives and less severe forms of extra-pulmonary TB.