Oral Anti-Tuberculosis Drugs: An Urgent Medication Reconciliation at Hospitals in Indonesia

Abstract

Background: Four oral anti-tuberculosis drugs are conceived to be the most effective ones to eradicate Mycobacterium tuberculosis bacteria and to obviate the resistant organisms. However, the patients' adherence and medication discrepancies are obstacles to achieving the goal. This study aimed to define the anti-tuberculosis drugs used in the hospitals and to detect the discrepancies in the continuity of the tuberculosis treatment.Design and Methods: This retrospective cross-sectional study was based on medical records of adult patients, and was conducted in two district tertiary care hospitals. Only 35 out of 136 patient records from Hospital A and 33 out of 85 records from Hospital B met the inclusion criteria.Results: The most common systemic anti-infective drugs in the study were ceftriaxone (51.80 DDD/100 patient-days) used in Hospital A and isoniazid (59.53 DDD/100 patient-days) used in Hospital B. The number of rifampicin prescriptions was less than that of isoniazid. Each patient received an average of two DDD/100 patient-days, which is an under dosage for an effective treatment.Conclusion: This study showed a medication discrepancy of Tuberculosis therapy. Tuberculosis patients’ medical histories are not under the full attention of treating physicians wherever they are admitted. Thus, medication reconciliation is needed to accomplish the goal of a Tuberculosis-free world in 2050.

Breaking barriers: The potential of nanosystems in antituberculosis therapy

“…The TB treatment from a clinical administration standpoint poses significant challenges, especially given the bioavailability issues associated with oral and intravenous drug delivery [ [116] , [117] , [118] ]. Although the oral administration route is the most widely used and practical method, its effectiveness is largely determined by the drug's ability to be absorbed through the intestinal wall [ 119 ]. Drug permeability across this selection barrier is crucial, and it is mainly impeded by the enteric epithelium and enzymatic degradation.…”