HIV and AIDS Treatment in Practice is a free-of-charge e-mail newsletter which has been launched for doctors, nurses and health care workers. The newsletter is published by a UK information charity. A voluntary advisory panel consisting of researchers and representatives from public, private and nongovernmental organizations will guide development of the information.

Each issue will review one major topic in HIV and AIDS treatment and will contain specialist comment. All articles are medically reviewed to ensure accuracy, balance and relevance.

HIV and AIDS Treatment in Practice is available on: http://www.aidsmap.com/main/hatip.asp.

Fixed-dose combinations for tuberculosis drugs

Ensuring that people with tuberculosis complete a full course of treatment is one of the major challenges of TB control. The risk is that uninformed patients or doctors may change the regimen, avoiding one or more of the drugs they believe are not necessary (or available) leading to treatment failure or relapse. In so doing, some of the patients may develop antimicrobial resistance.

There are various strategies to prevent non compliance, and one approach is through fixed-dose combination (FDC) tablets. Recent advances in pharmacology have now made it possible to develop quality combinations of two, three or four anti-TB drugs in a single tablet.

Prevention of drug resistance is just one of the potential benefits of FDCs. FDCs simplify administration of drugs by reducing the number of pills a patient takes each day and decreasing the risk of incorrect prescriptions - and, in particular, the risk of confusion by care-givers. Drug procurement - including stock management, shipping, and distribution - is simplified.

The World Health Organization has published an Operational Guide for National Tuberculosis Control Programmes on the Introduction and Use of Fixed Dose Combination Drugs. It provides easy-to-follow guidance on programmatic, managerial, quality and regulatory matters with practical approaches to facilitating use in a TB control programme. The guide contains minimum requirements and is not intended to replace existing requirements or practices. Approaches other than those described may also be applicable and acceptable and these should be chosen by the national tuberculosis programme. Above all, his tool will help managers understand the need to ensure bioavailability, comply with regulatory requirements and shift patients from regimens based on single-drug dosage.