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Free Content Evidence for promoting fixed-dose combination drugs in tuberculosis treatment and control: a review [Unresolved issues]

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Abstract:

Uptake of fixed-dosed combinations (FDCs) of anti-tuberculosis drugs remains low worldwide, despite decades of recommendations. FDCs are thought to be important tools for tuberculosis (TB) control and drug resistance (DR) prevention. However, evidence relating to this is limited. This article provides a critical review of the most relevant studies on anti-tuberculosis FDCs. The majority of published studies have sought to demonstrate that FDCs and single drugs have similar efficacy. This hypothesis has been proved with relation to similar sputum conversion, cure and relapse rates in a range of studies over the last 20 years using FDCs of two, three and four anti-tuberculosis drugs. However, one of the most relevant features of FDCs, the prevention of DR, has been addressed in only one study. Nevertheless, based on their similar efficacy, user-friendliness, lower costs, and operational and logistical advantages, generalised use of FDCs should continue to be recommended.

Keywords: FDC; MDR; TB; fixed-dose combinations; multidrug resistance; tuberculosis

Document Type: Invited Paper

DOI: https://doi.org/10.5588/ijtld.09.0439

Affiliations: 1: MDR-TB Unit, Tuberculosis Division, International Union Against Tuberculosis and Lung Disease, Paris, France; and Departament de Pediatria, Ginecologia i Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, Spain 2: MDR-TB Unit, Tuberculosis Division, International Union Against Tuberculosis and Lung Disease, Paris, France; Servicio de Neumología, Hospital General de Gran Canaria ‘Dr Negrin’, Las Palmas de Gran Canaria, Spain

Publication date: 2011-04-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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