Skip Navigation
Menu
Ideas and Opinions |15 June 1995

Fixed-Dose Combinations of Antituberculous Medications To Prevent Drug Resistance

Thomas Moulding, MD; Asim K. Dutt, MD; Lee B. Reichman, MD, MPH

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
Copyright ©2004 by the American College of Physicians
2004
  • From Harbor-University of California, Los Angeles, Medical Center, Torrance, California. Alvin C. York Veterans Administration Medical Center, Murfreesboro, Tennessee. New Jersey Medical School, Newark, New Jersey. Requests for Reprints: Thomas S. Moulding, MD, Division of Respiratory and Critical Care Physiology and Medicine, Harbor-University of California, Los Angeles, Medical Center, Torrance, CA 90501. Grant Support: By Cooperative Agreement 200-93-0636 from the Centers for Disease Control and Prevention; Tuberculosis Career Academic Award K07-h103015-01 from the Division of Lung Disease of the National Heart, Lung, and Blood Institute; and Research Consortium Grant 200-93-0690 from the Centers for Disease Control and Prevention.
×
FULL TEXT
Increasing resistance to antituberculous drugs is a major concern. The usual measures recommended for dealing with this problem are 1) increased supervision of tuberculosis treatment in the form of directly observed therapy that seeks to eliminate or reduce interruptions in treatment and 2) the provision of an adequate number of drugs in the initial treatment of patients when the possibility of drug resistance is anticipated [1]. These recommendations are entirely appropriate because breaks in therapy lead to the development of drug resistance and preexisting drug resistance leads to additional drug resistance if adequate chemotherapy is not given. Unfortunately, a third equally important measure for preventing the emergence of drug resistance, the use of fixed-dose combinations of antituberculous drugs to avoid monotherapy, has been largely ignored in the United States.
It is has been well known from the earliest days of chemotherapy for tuberculosis that two or more drugs are required to retard the emergence of drug resistance [2]. Unfortunately, patients sometimes take only one drug (monotherapy) when more than one drug is prescribed. This occurs because of a temporary lack of a supply of one or more medications; mistakes in dispensing; patients' decisions to purchase only one medication to save money; supplies of one medication lasting longer than supplies of other medications; loss of one medication; misunderstandings; and patients' deliberate decisions to take only one drug because of perceived or real symptoms associated with the other drug, such as arthralgias with pyrazinamide or red urine with rifampin. When...
FULL TEXT
PDF
Not Available
Citations
Citation

Moulding T, Dutt AK, Reichman LB. Fixed-Dose Combinations of Antituberculous Medications To Prevent Drug Resistance. Ann Intern Med. 1995;122:951–954. doi: https://doi.org/10.7326/0003-4819-122-12-199506150-00010

Download citation file:

© 2019

×
Permissions

Published: Ann Intern Med. 1995;122(12):951-954.

DOI: 10.7326/0003-4819-122-12-199506150-00010

61 Citations

Related Articles
Superinfection with Rifampin-Isoniazid-Streptomycin-Ethambutol (RISE)-resistant Tuberculosis in Three Patients with AIDS: Confirmation by Polymerase Chain Reaction Fingerprinting
Annals of Internal Medicine; 121 (2): 115-116
Initial Drug Resistance and Tuberculosis Treatment Outcomes: Systematic Review and Meta-analysis
Annals of Internal Medicine; 149 (2): 123-134
Short-Course Rifampin and Pyrazinamide Compared with Isoniazid for Latent Tuberculosis Infection: A Multicenter Clinical Trial
Annals of Internal Medicine; 137 (8): 640-647
Rare Outcomes, Common Treatments: Analytic Strategies Using Propensity Scores
Annals of Internal Medicine; 137 (8): 693-695
View MoreView Less

Journal Club
Isoniazid prevented active tuberculosis in patients with HIV treated with antiretroviral therapy
Annals of Internal Medicine; 161 (6): JC12
In adults with S aureus bacteremia, adding rifampin to standard antibiotic therapy did not improve outcomes
Annals of Internal Medicine; 168 (6): JC32
A model was sensitive but not specific for screening for tuberculosis in contact patients
Annals of Internal Medicine; 149 (8): JC4-15
In HIV-1, immediate vs deferred antiretroviral therapy and isoniazid vs no isoniazid reduced severe illness at 30 mo
Annals of Internal Medicine; 163 (12): JC5
View MoreView Less

Related Point of Care
Tuberculosis
Annals of Internal Medicine; 166 (3): ITC17-ITC32
Tuberculosis
Annals of Internal Medicine; 150 (11): ITC6-1
View MoreView Less

Related Topics
Infectious Disease
Mycobacterial Infections

Infectious Disease, Mycobacterial Infections.

PubMed Articles
Penile tuberculid successfully treated with anti-tuberculosis regimens.
Dermatol Ther 2019.
MEGARes 2.0: a database for classification of antimicrobial drug, biocide and metal resistance determinants in metagenomic sequence data.
Nucleic Acids Res 2019.
View More

Results provided by: PubMed

CONTINUE WITH LIMITED ACCESS
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×