TB recurrence & treatment B9402037 陳名揚. Successful treatment more than one drug to which the organisms are susceptible appropriate doses take drugs regularly.

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Presentation transcript:

TB recurrence & treatment B 陳名揚

Successful treatment more than one drug to which the organisms are susceptible appropriate doses take drugs regularly continue for a sufficient period of time

Recurrent tuberculosis Duration of therapy – 1.4, 2.0, 4.0 ( 每 100 人 )  >=7 mons, 5~6 m, 2~3m HIV infected Other risk factors – Treatment: thrice weekly > daily – TB expend

Patient nonadherence symptoms medical availability side effects Dosing frequency The length of treatment Personal and social characteristics Cultural Public health system TB treatment available patient's knowledge health care providers Political, legislative, and economic factors

Groups at risk for nonadherence Patients who have failed previous anti-TB regimens Who have difficulty remembering to take medications on a regular basis. Individuals actively abusing drugs, alcohol, or other addictive substances may have impaired cognition and distorted priorities. A poor caregiver-patient relationship distinct cultural or ethnic groups

STRATEGIES TO IMPROVE PATIENT ADHERENCE DOT (direct observe therapy) Modified regimen – trice or twice per week Drugs combination Incentives and enablers Patient education Reminder case management Long-term hospitalization P.s. Three aditional drug for relapse or life-threatened patients.

Uptodate - Treatment of tuberculosis in HIV- negative patients Uptodate - Adherence to tuberculosis treatment