Is directly observed therapy (DOT) with short course chemotherapy for active tuberculosis (TB) appropriate to everyday clinical practice?

L. J. Seeto, E. M. Lagaac, A. J. Ing, M. Peters, A. B X Breslin

Research output: Contribution to journalArticle

Abstract

In the context of trials, short course chemotherapy with DOT has been shown to have 98% cure rates. We wished to establish that these results could be replicated in routine clinical practice and that a high level of DOT compliance was achievable. Methods: A retrospective analysis was undertaken of all cases of TB seen at Concord Hospital in the period 19851996 inclusive.Short course DOT is the stated preferred treatment approach in this clinic.Cure was defined as no evidence of relapse during a mean follow up of 24 months. Results: 319 patients aged 4-94 years (mean 53) with active TB were identified. The characteristics of the group are shown. Patients Overseas born Pulmonary TB Nonpulmonary TB Multidrug Resistance Number 319 219 242 77 3 86% completed 6 or more months therapy, 89% of whom had DOT 3 times per week. The remainder either left Australia, died during treatment of unrelated causes, or ceased treatment because of side effects. Only 2 relapses occurred, both with pulmonary TB. One left Australia after 2 months therapy and relapsed on return 2 years later. The other stopped treatment after 3.5 months because of side effects and relapsed within 12 months. Conclusions: (1) DOT was found to be practical and achievable with a >75% compliance in clinical practice. (2) A >98% cure rate for TB at all sites is to be expected in the routine clinical setting if the basic principles of DOT are adhered to.

Original languageEnglish
Pages (from-to)A55
Number of pages1
JournalRespirology
Volume4
Issue numberSUPPL. 1
Publication statusPublished - 1999
Externally publishedYes

Keywords

  • Directly observed therapy
  • Short course chemotherapy
  • Tuberculosis

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