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"Background: a patient with a history of tuberculosis (TB) has a risk up to 27% to develop recurrence within 2 years after being cured. Indonesia itself has more than 7,500 recurrent cases annually, regardless of reinfection or relapse. This is an important problem, as recurrent TB is associated with lower cure rates with the anti-TB therapy and higher risk of developing drug resistance. Some risk factors for this recurrence are smoking, poor treatment adherence, low economic status, and weak immune status. This study is aimed to identify whether the use of fixed-dose combination (FDC) anti-tuberculosis therapy increases the risk for tuberculosis recurrence compared with using separate drug formulation.Methods: the search was conducted on MEDLINE, ProQuest, EBSCO, ScienceDirect, and Cochrane according to clinical question. The studies were selected based on inclusion and exclusion criteria and led to five useful articles. The selected studies were critically appraised for their validity, importance, and applicability.Results: five cohort studies were found with comparable validity. Only 1 study has accurate relative risk (RR) with 3.97 (1.14-13.80) and number needed to harm of 18. Other four studies fulfilled the applicability criteria for our case.Conclusion: the use of FDC anti-tuberculosis therapy increases the risk for tuberculosis recurrence compared with using separate drug formulation."

"ABSTRAKRifampisin merupakan senyawa antibiotik golongan makrolida yang berkhasiat sebagai antituberkulosis yang menghambat inisiasi pembentukan rantai RNA pada bakteri. Pemantauan terapi obat dengan menggunakan kertas sampel darah kering memberikan beberapa keuntungan dibandingkan dengan plasma yaitu minimum invasif pada pasien, volume darah yang dibutuhkan sedikit, analit relatif stabil, mudah dalam distribusi dan penyimpanan, tidak membutuhkan tenaga phlebotomist, mengurangi resiko infeksi dan hemat biaya. Rifampisin dapat memberikan efek terapi apabila kadar pada konsentrasi maksimum mencapai 8-24 g/ml. Analisis rifampisin dilakukan pada 18 orang pasien tuberkulosis di rumah sakit umum daerah Bekasi yang mendapatkan regimen rifampisin dalam bentuk kombinasi dosis tetap dengan isoniazid. Darah yang digunakan sebagai sampel diambil pada 2 jam dan 6 jam setelah pemberian rifampisin masing-masing sebanyak 100 l. Analisis rifampisin dilakukan menggunakan kromatografi cair kinerja tinggi detektor UV. Kurva kalibrasi rifampisin linear pada rentang konsentrasi 1 ndash;30 g/ml. Hasil analisis konsentrasi rifampisin pada 18 pasien tuberkulosis menunjukkan bahwa konsentrasi rifampisin yang terukur berada pada rentang 1,26 g/ml hingga 18,33 g/ml. Hal ini menunjukkan bahwa konsentrasi terukur pada rifampisin bervariasi antar pasien. Pada hasil analisis, terdapat 7 dari 18 pasien yang memiliki konsentrasi dalam rentang terapi, hal ini menunjukkan bahwa dosis yang diberikan sudah tepat. Sedangkan 11 dari 18 pasien memiliki konsentrasi dibawah rentang terapi sehingga membutuhkan penyesuaian dosis.

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ABSTRACTRifampicin is an antibiotic from macrolide group using for anti tuberculosis, which block initiation of comformation RNA chain of bacteria. Therapeutic drug monitoring using dried blood spots had some advantages such as less invasive, just need a small volume, analyte relatively stable, easy in distribution and storage, doesn rsquo t need a phlebotomist, reduce the risk of infection and cost effectiveness. Rifampicin may provide therapeutic effect if have a maximum concentration of 8 24 g ml. Rifampicin analysis was performed on 18 tuberculosis pasients in General Bekasi Hospital who get rifampicin in fixed dose combination which is containing isoniazid. The blood sample was taken 2 hours and 6 hours after oral administration of tablet as much as 100 l. Rifampicin analysis had determined by high performance liquid chromatography UV detector. Rifampicin calibration curve had linear in the range of 1 30 g ml. Result of the analysis of rifampicin in 18 tuberculosis patients showed the measured value of rifampicin are in the range of 1.26 to 18.33 g ml. Based on the result,the concentration of rifampisin in patients were varied. There were 7 of 18 patients had concentration in therapeutic range, it shows that the treatment is appropriate. While 11 of 18 patients had concentration below the therapeutic range, it means that it need the dose adjustment. "