Desfechos clínicos do tratamento de tuberculose utilizando o esquema básico recomendado pelo Ministério da Saúde do Brasil com comprimidos em dose fixa combinada na região metropolitana de Goiânia

Ferreira, Anna Carolina Galvão; Júnior, José Laerte Rodrigues da Silva; Conde, Marcus Barreto; Rabahi, Marcelo Fouad

doi:10.1590/s1806-37132013000100011

Cited by 20 publications

(35 citation statements)

References 11 publications

(20 reference statements)

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“…However, regarding the treatment abandonment in the sample, negative results are revealed in the study period, with the abandonment rate being higher than the 5% recommended by the MS (2) . However, the results were better than those observed in Goiânia / GO (17,5%) (8) and Recife / PE (15%) (4) . Studies on treatment abandonment point to causes associated with patient characteristics, such as being male, Lima LM, Harter J, Tomberg JO, Vieira DA, Antunes ML, Cardozo-Gonzales RI having work commitments (3) , low education and a previous record of abandonment (4) .…”

Section: Discussioncontrasting

confidence: 59%

“…Cure rates throughout the study period were higher than the 85% recommended by the MS (2) . In similar studies, lower rates were yielded, with a 75.3% cure rate in a study held in Argentina (7) , a 71% cure rate in a study conducted in Recife / PE (4) and a 67.5% cure rate in research conducted in Goiânia / GO (8) . It is considered that this result is a positive mark for the service under study.…”

Section: Discussionmentioning

confidence: 85%

“…It is known that the basic principles for successful treatment include choosing the appropriate treatment regimen in correct doses, and compliance with the time of treatment, besides conducting clinical follow-ups with the adoption of health education practices and observing treatment strategy (DOTS) (4)(5) . It is observed that there are updated publications on the monitoring of patients with TB, on laboratory and radiological tests (6)(7) and on the outcomes of treatment, showing that, globally, cure rates have not been reached, and that the abandonment rates are higher than expected (3)(4)(5)(6)(7)(8) . However, there is a need to increase production regarding the follow-up actions, as well as to know the outcome of treatment for TB in southern Brazil, when considering the epidemiological importance of the disease in this setting.…”

Section: Introductionmentioning

confidence: 99%

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Avaliação do acompanhamento e desfecho de casos de tuberculose em município do sul do Brasil

Lima

Härter

Tomberg

et al. 2016

Rev. Gaúcha Enferm.

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RESUMO Objetivos avaliar o acompanhamento e desfecho do tratamento de casos de tuberculose pulmonar no programa de controle da tuberculose de um município prioritário do Sul do Brasil. Métodos estudo quantitativo, descritivo, documental, utilizando prontuários das pessoas com tuberculose em tratamento entre 2009-2013, a coleta ocorreu entre junho e julho de 2014 no Programa de Controle da Tuberculose. Utilizou-se estatística descritiva. Resultados a média de consultas, entre os 629 pacientes, foi de 7,2 por paciente, com intervalo médio de 1,03 meses entre as consultas. A média de baciloscopias foi de 2,7 exames por paciente, durante o período estudado. O desfecho do tratamento foi 87,8% de cura, 8,3% de abandono e 6,5% de óbitos. Conclusões apesar do alcance da taxa de cura, o abandono ainda é elevado, sendo necessário explorar estratégias para melhor a adesão ao tratamento, e o comprometimento da gestão municipal em articular o acompanhamento na atenção primária à saúde.

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Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

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Avaliação do acompanhamento e desfecho de casos de tuberculose em município do sul do Brasil

Lima

Härter

Tomberg

et al. 2016

Rev. Gaúcha Enferm.

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“…These data strongly suggest that the use of FDC tablets does not have a significant impact on adherence to treatment. Therefore, measures to improve adherence, such as supervised treatment, should not be neglected 11 . In addition, studies conducted in Brazil have demonstrated the association between lower rates of treatment abandonment and supervised treatment 39, 40, 41…”

Section: Discussionmentioning

confidence: 99%

“…Fixed-dose combinations (FDCs) of drugs for TB treatment have been advocated internationally to prevent the emergence of drug resistance attributable to inappropriate drug intake 10, 11. Use of FDCs can reduce the risk of an incorrect dosage, simplify drug procurement, and aid in ensuring adherence without changing the drug dosage.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of a four-drug fixed-dose combination regimen versus separate drugs for treatment of pulmonary tuberculosis: a systematic review and meta-analysis

Lima¹,

Silva

Magalhães

et al. 2017

Brazilian Journal of Microbiology

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IntroductionTuberculosis, particularly multi-drug-resistant tuberculosis, is a major cause of morbidity and mortality worldwide. To the best of our knowledge, however, no study to date has assessed the combined use of the four available drugs for tuberculosis treatment, which is an issue of great clinical relevance.ObjectiveTo determine whether the four-drug fixed-dose combination is safer or more effective than separate drugs for treatment of pulmonary tuberculosis.MethodsA systematic review of the literature was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsIn pooled results from five randomized controlled trials with 3502 patients across Africa, Asia, and Latin America, four-drug fixed-dose combination therapy was no better than separate drugs therapy in terms of culture conversion after 2 and 6 months of treatment. There were no significant differences between the groups in overall incidence of adverse effects. However, the meta-analytic measure (log odds ratio) revealed that separate drugs treatment had a 1.65 [exp (0.5) = 1.65] increased chance of gastrointestinal adverse effects compared to four-drug fixed-dose combination treatment.ConclusionsThe reviewed studies showed that four-drug fixed-dose combination therapy provides greater patient comfort by reducing the number of pills and the incidence of gastrointestinal adverse effects, as well as simplifying pharmaceutical management at all levels.

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Fixed-dose combinations of drugs versus single-drug formulations for treating pulmonary tuberculosis

Gallardo

Comas

Rodríguez

et al. 2016

Cochrane Database of Systematic Reviews

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Background People who are newly diagnosed with pulmonary tuberculosis (TB) typically receive a standard first‐line treatment regimen that consists of two months of isoniazid, rifampicin, pyrazinamide, and ethambutol followed by four months of isoniazid and rifampicin. Fixed‐dose combinations (FDCs) of these drugs are widely recommended. Objectives To compare the efficacy, safety, and acceptability of anti‐tuberculosis regimens given as fixed‐dose combinations compared to single‐drug formulations for treating people with newly diagnosed pulmonary tuberculosis. Search methods We searched the Cochrane Infectious Disease Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL, published in the Cochrane Library, Issue 11 2015); MEDLINE (1966 to 20 November 2015); EMBASE (1980 to 20 November 2015); LILACS (1982 to 20 November 2015); the metaRegister of Controlled Trials; and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), without language restrictions, up to 20 November 2015. Selection criteria Randomized controlled trials that compared the use of FDCs with single‐drug formulations in adults (aged 15 years or more) newly diagnosed with pulmonary TB. Data collection and analysis Two review authors independently assessed studies for inclusion, and assessed the risk of bias and extracted data from the included trials. We used risk ratios (RRs) for dichotomous data and mean differences (MDs) for continuous data with 95% confidence intervals (CIs). We attempted to assess the effect of treatment for time‐to‐event measures with hazard ratios and their 95% CIs. We used the Cochrane 'Risk of bias' assessment tool to determine the risk of bias in included trials. We used the fixed‐effect model when there was little heterogeneity and the random‐effects model with moderate heterogeneity. We used an I² statistic value of 75% or greater to denote significant heterogeneity, in which case we did not perform a meta‐analysis. We assessed the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Main results We included 13 randomized controlled trials (RCTs) in the review, which enrolled 5824 participants. Trials were published between 1987 and 2015 and included participants in treatment with newly diagnosed pulmonary TB in countries with high TB prevalence. Only two trials reported the HIV status of included participants. Overall there is little or no difference detected between FDCs and single‐drug formulations for most outcomes reported. We did not detect a difference in treatment failure between FDCs compared with single‐drug formulations (RR 1.28, 95% CI 0.82 to 2.00; 3606 participants, seven trials, moderate quality evidence ). Relapse may be more frequent in people treated with FDCs compared to single...

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Desfechos clínicos do tratamento de tuberculose utilizando o esquema básico recomendado pelo Ministério da Saúde do Brasil com comprimidos em dose fixa combinada na região metropolitana de Goiânia

Cited by 20 publications

References 11 publications

Avaliação do acompanhamento e desfecho de casos de tuberculose em município do sul do Brasil

Avaliação do acompanhamento e desfecho de casos de tuberculose em município do sul do Brasil

Efficacy and safety of a four-drug fixed-dose combination regimen versus separate drugs for treatment of pulmonary tuberculosis: a systematic review and meta-analysis

Fixed-dose combinations of drugs versus single-drug formulations for treating pulmonary tuberculosis

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