4. A ten-year study of pharmacotherapeutic approach to tuberculosis at a tertiary hospital in south west Nigeria

A retrospective study of a ten-year pharmacotherapeutic approach in the management of tuberculosis (TB) at the University College Hospital Ibadan was made. The primary purpose was to evaluate the treatments outcome of the therapeutic regimen prescribed during a period of ten years. A total number of 975 case notes from medical records of outpatients and inpatients with tuberculosis were thoroughly studied. This represented 492 (50.5%) males and 483 (49.5%) females. Nine hundred and three (903) (92.6%) were new cases, 32 (3.4%) were relapse cases, 3 (0.3%) were failure cases from previous TB treatment, 26 (2.7%) were returned cases after default treatment and 10 (1.0%) cases were transferred. The anti TB regimen reviewed showed the prescribed drugs to be 2RHZE/6RH 661 (67.8%), 2RHZE/6EH 182 (18.7%), 2SHRZE/6RHZE 26 (2.7%), 2SRHZE/RHZE/6RH 32 (3.3%) and others 47 (4.8%), where R= Rifampicin (RMP), H= Isoniazid (INH), Z= Pyrazinamide (PZA), E= Ethambutol (EMB) and S= Streptomycin (STM). The major concomitant drugs prescribed were multivitamins 364 (37.3%) analgesics 340 (34.9%), other antibiotics 229 (23.5%), expectorants 197 (20.2%), antimalarials 174 (17.8%), antihistamines 147 (15.1%), bronchodilators 77 (7.9%), antacids 49 (5.0%), and pyridoxine 333 (34.2%). Side effects documented were visual impairment 43 (13.2%), pedal oedema 14 (4.3%), peripheral neuropathy 20 (6.2%), insomnia 40 (12.3%), gastrointestinal side effects 88 (27.1%), headache 13 (4.0%), rashes 10 (3.1%), liver dysfunction 6 (1.8%), arthralgia 28 (8.6%), irrational behaviour 8 (2.5%), pruritus 15 (4.6%), palpitations 3 (0.9%), anaemia 7 (2.19%), hearing impairment 2 (0.6%) and others 24 (7.5%). The findings revealed that consideration should be given to co-existing disease conditions and current medication needs of TB patients.