Abstract:

Objective: To analyze the use of anti-tuberculosis fixed-dose combinations (FDC) in Fujian Province and its influencing factors, so as to provide evidence for expanding FDC adoption and promoting standardized tuberculosis treatment. Methods: A total of 18 tuberculosis designated hospitals were selected from 9 cities and Pingtan comprehensive experimental area in Fujian Province based on typical sampling method. A total of 980 patients with rifampicin-susceptible pulmonary tuberculosis who met the enrollment criteria and were registered and treated from January 1, 2020 to December 31, 2021 were enrolled. The use or replacement of FDC were analyzed. A two-level logistic model was used to analyze the factors affecting the use of FDC. Results: Among 980 tuberculosis patients, 80.41% (788/980) used FDC as initial treatment drugs. The two-level logistic model analysis showed that patients aged 60-90 years and with complications/comorbidities were risk factors for not using FDC (OR=1.499, 95%CI: 1.000-2.247, P=0.049; OR=1.844, 95%CI: 1.231-2.761, P=0.003), while patients with body mass 38-54 kg, 55-70 kg and 71-90 kg were more likely using FDC (OR=0.297, 95%CI: 0.123-0.721, P=0.007; OR=0.334, 95%CI: 0.136-0.823, P=0.017; OR=0.217, 95%CI: 0.065-0.722, P=0.013). 16.50% (130/788) of patients who initially treated with FDC switched to single-drug formulations in subsequent treatment. The replacement rate of FDC was significantly different between variable regions (2.96% (4/135) -32.00% (24/75),χ²=50.752, P<0.001). The replacement rate was also significantly different between 60-90 years group (20.45% (54/264)) and 13-59 years group (14.50% (76/524))(χ²=4.513, P=0.034). Conclusion: The usage rate of anti-tuberculosis FDC in Fujian Province is about 80%, and there are significant differences between different regions. Age, body weight, and complications/comorbidities are factors associated with the use of FDC.

Key words: Tuberculosis, pulmonary, Fixatives, Factor analysis, statistical