Operational Guide for National Tuberculosis Control Programmes on the Introduction and Use of Fixed-Dose Combination Drugs
(2002; 81 pages) View the PDF document
Table of Contents
View the documentACKNOWLEDGEMENTS
View the documentLIST OF ACRONYMS AND ABBREVIATIONS
View the documentPREFACE
View the documentKEY POINTS
Open this folder and view contents1. INTRODUCTION
Open this folder and view contents2. PROGRAMMATIC AND MANAGERIAL REQUIREMENTS FOR FDCS
Close this folder3. FDC DRUG MANAGEMENT
View the document3.1 Product selection
Open this folder and view contents3.2 Procurement
View the document3.3 Distribution and storage
View the document3.4 Rational use of anti-TB medicines
View the document3.5 Drug problem reporting system
View the document3.6 Monitoring and evaluation
View the document3.7 Summary checklist for good anti-TB drug management
Open this folder and view contents4. ENSURING THE QUALITY OF FDC DRUGS
Open this folder and view contents5. HOW TO INTRODUCE AND CHANGE OVER TO A REGIMEN WITH 4-DRUG FDCS/2-DRUG FDCS: PLANNING AND IMPLEMENTING A "SCENARIO"
View the documentAnnex 1. Glossary and use of terms
View the documentAnnex 2. WHO Certification Scheme - Model Certificate of a Pharmaceutical Product1
View the documentAnnex 3. WHO Certification Scheme - Model Batch Certificate of a Pharmaceutical Product
View the documentAnnex 4. Example of an order form for anti-TB drugs for treatment facilities
View the documentAnnex 5. Steps in the quantification of anti-TB drugs using consumption-based information
View the documentAnnex 6. Suggested reading
View the documentRequest for feedback on the guide
 

3.4 Rational use of anti-TB medicines

Rational drug use is the process of correct diagnosis followed by correct prescribing of, labelling of, dispensing of, and ensuring that the patient adheres to, recommended treatment regimens. Anti-TB drug use by prescribers and patients is described in section 2. An important area of drug use is that of prescribing and dispensing the right drugs to the patient, and good prescribing and dispensing practices should not be overlooked. Fixed-dose combinations promote good practices and can contribute to fewer prescribing and dispensing errors because there are fewer tablets to handle at one time.

Some TB control programmes have instituted the use of patient kits, where all drugs for the intensive phase are placed in a box labelled with the patient's name. This assures the availability of drugs for that patient during this important phase of treatment. Fixed-dose combinations facilitate the preparation of patient kits. However, the use of patient kits does not replace DOT. Prescriber and patient compliance to drug regimens is a key factor in treatment success, and NTP managers must be sure that drug use practices are in accordance with the adopted standard treatment guidelines. Selected key indicators (e.g. percentage of new smear-positive patients with pulmonary TB who were prescribed correct drugs in correct dosages with correct duration, based on the standard treatment guidelines) should be developed and included in the TB programme monitoring system.

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Last updated: May 3, 2013