Drug prescribing practices for tuberculosis in Uzbekistan

Int J Tuberc Lung Dis. 2009 Nov;13(11):1405-10.

Abstract

Setting: Uzbekistan has had 100% DOTS coverage since 2005; however, the treatment success rate has remained at around 80% for the last 4 years. Surveys from the capital city of Tashkent and from western Uzbekistan have shown high levels of primary multidrug resistance.

Objective: To assess treatment regimens prescribed for new cases of tuberculosis (TB), including the prescription of additional non-TB drugs, and the cost implications for the patient.

Design: We randomly sampled 30 clusters of seven new TB patients. Enrolled patients were interviewed and their medical records were reviewed.

Results: In general, the treatment regimens prescribed were correct; doses were high rather than low. Second-line anti-tuberculosis drugs were rarely prescribed. In addition to anti-tuberculosis drugs, patients were prescribed on average seven to eight non-TB drugs. The rationale for prescribing the non-TB drugs was, however, questionable. Patients incurred substantial costs for these drugs, some of which were not without risk.

Conclusion: Prescriptions of anti-tuberculosis drugs for new TB patients are adequate; however, the practice of prescribing additional non-TB drugs needs to be reconsidered.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents / economics
  • Antitubercular Agents / therapeutic use*
  • Drug Costs
  • Drug Prescriptions
  • Drug Therapy, Combination
  • Drug Utilization
  • Evidence-Based Medicine
  • Female
  • Guideline Adherence
  • Humans
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'*
  • Retrospective Studies
  • Tuberculosis / diagnosis
  • Tuberculosis / drug therapy*
  • Tuberculosis / economics
  • Tuberculosis / epidemiology
  • Uzbekistan / epidemiology
  • Young Adult

Substances

  • Antitubercular Agents