Treatment outcomes and adverse events associated with intermittent versus daily continuation-phase regimens in drug-susceptible tuberculosis patients in Makassar, Indonesia: an observational cohort study.

Authors

Latifah Mahaya Sarifah, Jamaluddin Madolangan, Akhmad Ardiansyah, Saidah Rauf, Andi Julia Junus, Sylmina Dalily Alkaff, Maarten J Postma, Firas Farisi Alkaff, Muhammad Syahrir, Bustanul Arifin

Published in

BMC infectious diseases. Jul 04, 2026. Epub Jul 04, 2026.

Abstract

Indonesia has one of the highest number of tuberculosis (TB) cases globally. The previous treatment policy of the Ministry of Health was to administer TB drugs intermittently (three times per week) during the continuation phase. Since 2023, the treatment policy has changed to daily dosing during the continuation phase. However, evidence comparing the treatment outcomes and tolerability of these agents remains limited.
This study compared patient characteristics, treatment success, and reported adverse events between intermittent and daily regimens among drug-susceptible TB patients.
An observational cohort study was conducted using secondary data from medical records and the National TB Information System, with prospective ascertainment of adverse events via standardized telephone and face-to-face interviews among a subset of participants. Group comparisons were performed using chi-square tests, t-tests, and multivariable logistic regression (adjusted for age, HIV status, diabetes status, and baseline sputum).
A total of 532 drug-susceptible TB patients were included (intermittent n = 247; daily n = 285). The daily group had a higher mean age and a greater proportion of HIV-positive and diabetic patients (p < 0.05). Treatment success rates were comparable between the two groups (87.85% vs. 87.37%; p = 0.850), with no significant association observed in the adjusted analyses (aOR = 1.23 [0.69-2.18]; p = 0.494). Among 327 patients with adverse event data available (61.47%), reported adverse events were more frequent in the daily group (100.00% vs. 84.38%; p < 0.001), particularly nausea/vomiting/fatigue/fever (aOR = 3.03; 95% CI: 1.69-5.55) and itching (aOR = 2.07; 95% CI: 1.27-3.41); however, these findings were based on a subset of participants and may be subject to recall and reporting bias.
Intermittent and daily continuation-phase regimens showed comparable treatment success in this observational study. Among participants with available adverse event data, daily dosing was associated with more frequently reported adverse events; however, causal inference could not be made due to non-random regimen allocation, baseline differences between groups, incomplete ascertainment of adverse events, and potential recall and reporting bias. These findings suggest the potential importance of routine tolerability monitoring and targeted patient support in programmatic TB care, though confirmation from multicenter prospective studies is needed given the single-center design and incomplete adverse event ascertainment.
Clinical trial number: not applicable.

PMID:
42401852
Bibliographic data and abstract were imported from PubMed on 05 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.