Treatment of bacillary pulmonary tuberculosis at the chest clinics in the private sector in Korea, 1993

SETTING: Cohort study of bacillary pulmonary tuberculosis patients treated at private sector chest clinics in Korea. OBJECTIVE: To assess the treatment behaviour of physicians in private chest clinics and the treatment outcomes of their patients. DESIGN: 1) A retrospective analysis of a cohort of patients admitted from J uly through October in 1993, and 2) comparison with results from health cen tres under the National Tuberculosis Programme (NTP). RESULTS: Nine hundred and sixty bacillary patients (507 newly diagnosed-'ne w', and 453 retreatment-'old') were admitted to the study. Initial smears a nd cultures were not performed in 7% and 21%, and followup smears and cultu res not done in 19% and 28%, respectively. The regimens prescribed were var iable: 23 in 'new' and 72 in 'old' patients, 86 in total. Six-month short-c ourse treatment using HRZE was prescribed for 26.2% of 'new' patients. In m any instances, the planned treatment duration was excessive. The success ra tes (cured plus completed) for 'new' and 'old' patients were 74% and 51%, r espectively. The failure rates were less than 1% in 'new' and 9% in 'old' p atients. CONCLUSION: Prescribed regimens were variable in terms of drug combinations and treatment duration. Overall treatment outcome was inferior to that of the health centres under the NTP.