Changing from single-drug to fixed-dose combinations: experience from Fiji.

Background: Fixed-dose combinations (FDCs) of first-line anti-tuberculosis drugs were introduced in Fiji in 2011, and there have been concerns about treatment response.

Objective: To evaluate the treatment response to FDCs among tuberculosis (TB) patients.

Methods: A retrospective cohort study was undertaken of treatment outcomes of new TB cases registered from January 2010 to April 2013 and weighing ⩾30 kg. Sputum smear conversion of new sputum smear-positive cases and end-of-treatment outcomes of all cases were evaluated for those receiving FDCs and compared to outcomes with previous use of single-drug preparations.

Results: Among new TB patients, 240 received single-drug preparations and 259 received FDCs for the full duration of treatment. The groups were similar in terms of demographic and clinical characteristics. Treatment outcomes were available for 95% of cases. Unknown outcomes were more common in those receiving FDCs. When known, end-of-treatment outcome was the same in the two treatment groups and did not differ between TB types. Sputum smear conversion after the 2-month intensive phase of treatment was similar in the two treatment groups: 95% and 97%, respectively.

Conclusions: The introduction of FDCs in Fiji for the treatment of TB cases has not been associated with changes in treatment response.