Factors cause of switching shorter regimen to longer regimen in multidrug-resistant/ rifampicin-resistant tuberculosis treated patients in dr. Soetomo hospital surabaya, indonesia

Abstract

Background: Indonesia started to implement the Shorter Regimen (STR) since 2017, but not all of MDR/ RR-TB patients were treated with STR until the end of treatment. The presence of side effects of one or several drugs in the STR and the resistance to fluoroquinolone and or 2nd line injection drug after starting treatment caused a switch in regimen from STR to a longer regimen. This study was conducted to evaluate the factors that caused switch STR to the longer regimen. Methods: This was a descriptive study in MDR/RR-TB patients who received STR from October 2017 to December 2019. Patients who switch their regimen were analyzed and determine the factors cause of switching STR to a longer regimen. Conclusion: The major cause of switching was due to the presence of resistance to fluoroquinolone and 2nd line injection drugs and incidence of prolonged QT. A diagnostic rapid test such as the line probe assay 2nd line TB drugs is absolutely a screening tool to determine MDR-TB patients, pre-XDR-TB or XDR TB as soon as the regimen is given. Monitoring and efforts to overcome prolonged QT side effects are also needed to prevent switch regimens that can affect the patient’s psychological condition.