Use of anti-tuberculosis drugs among newly diagnosed pulmonary tuberculosis inpatients in China: a retrospective study

摘要

Background:China’s national tuberculosis control program(NTP)provides free,first-line anti-tuberculosis(TB)drugs to pulmonary TB patients.This treatment regimen follows the World Health Organization’s(WHO)guideline.The objective of this paper is to evaluate the current status of anti-TB drug use for newly diagnosed pulmonary TB inpatients treated in prefecture-and county-level designated hospitals.Methods:Three prefecture-level hospitals and nine county-level hospitals were selected for the study.All newly diagnosed pulmonary TB inpatient medical records from 2012 were reviewed and doubly examined by two national senior physicians.The rational use of anti-TB drugs was evaluated based on criteria in line with WHO’s guideline.Results:Of the 2,060 total treatment regimens for TB,53.1%were found to be rational(1093/2060).The percentages in prefecture-level and county-level hospitals were 50.3%(761/1513)and 60.7%(332/547),respectively.The difference between the two levels of hospitals was statistically significant(Chi-square value=17.44,P<0.01).The percentages of rational treatment regimens for first-time hospitalizations and for two or more hospitalizations were 59.5%(983/1653)and 27.0%(110/407),respectively,with a statistically significant difference(Chi-square value=138.00,P<0.01).The overall use of second-line drugs(SLD)was 54.9%(1131/2060).The percentages for prefecture-level and county-level hospitals were 50.6%(766/1513)and 66.7%(365/547),respectively.A statistically significant difference was found(Chi-square value=42.06,P<0.01).The use of SLD for inpatients hospitalized once and inpatients hospitalized twice or more was 58.4%(966/1653)and 40.5%(165/407),respectively,with a statistically significant difference(Chi-square value=42.26,P<0.01).Conclusions:Half of inpatients might be treated with irrational regimens,and the use of SLD was more appropriately dispensed in city-level hospitals than in county-level hospitals.Trainings and guidelines for health personnel,supervision led by health authorities and increased investment to designated hospitals may help to improve the rational use of anti-TB drugs.