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Letters to the Editor
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Tuberculosis
Many opportunities for pharmacists
From Mr T. W. Rennie, MRPharmS
I would like to express great satisfaction and commend the authors of
the recent series of
extensive articles relating to tuberculosis (TB).
I would, however, like to emphasise a number of points which I believe
are pertinent.
The economic aspect of treating multidrug-resistant TB (MDR-TB) is highly
significant. Treatment for MDR-TB has been estimated to be about 10 times
more expensive (£54,000– £60,000) than treating fully
sensitive TB (£6,040).1
DOTS (directly observed treatment, short course) is a comprehensive five-point
policy promoted by the World Health Organization and not implemented
in the UK due to the low incidence rate.2 A three-month alternative chemoprophylaxis
regimen, rifampicin plus isoniazid, recommended in British Thoracic Society
guidelines3 may be preferred to six-months of isoniazid because of its
shorter duration. Either regimen is suitable.
Finally, with the notable exception of streptomycin, most first-line
antituberculous drugs are considered safe for use in pregnancy and breastfeeding
for treatment of TB, and even chemoprophylaxis of TB infection using
isoniazid.4
A fifth article in the series could have described future roles for pharmacists,
such as adherence counselling, or various research activities relating
to TB. There are many opportunities for pharmacists to be directly involved
in TB care.
Tim Rennie
Research Pharmacist
Department of Practice and Policy,
The School of Pharmacy, London
References
1. White VL, Moore-Gillon J. Resource implications of patients with
multidrug resistant tuberculosis. Thorax 2000;55:962–3.
2. World Health Organization. Global tuberculosis control: surveillance,
planning, financing. WHO Report 2003. Geneva: WHO; 2004.
3. Joint Tuberculosis Committee of the British Thoracic Society. Control
and prevention of tuberculosis in the United Kingdom: code of practice
2000. Thorax 2000;55:887–901.
4. Bothamley GH. Drug treatment for tuberculosis during pregnancy. Drug
Safety 2001;24:553–65. |
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