Analysis Success Rate Of BPAL/M Therapy For Drug Resistant Tuberculosis

Chicy Widya Morfi* -  Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Lampung University, Indonesia
Retno Ariza Soemarwoto -  Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Lampung University, Indonesia
Tetra Arya Saputra -  Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Lampung University, Indonesia
Laisa Azka -  Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Lampung University, Indonesia
Adityo Wibowo -  Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Lampung University, Indonesia
Naufal Rafif Putranta -  Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Lampung University, Indonesia
DOI : 10.33024/jkm.v11i8.22105

Supp. File(s): Research Instrument common.other

Latar Belakang: Tuberkulosis (TB) adalah penyakit yang dapat dicegah dan biasanya dapat disembuhkan. Tuberkulosis menyebabkan sekitar 1,25 juta kematian di dunia pada tahun 2023. Secara global, diperkirakan terdapat 450 ribu kasus baru tuberkulosis multi-drug resistant (MDR) atau tuberkulosis rifampicin resistant (RR) pada tahun 2021. Tantangan dalam pengobatan Tuberkulosis Resisten Obat (TB-RO) diantaranya adalah jangka waktu pengobatan yang lebih lama menggunakan OAT lini kedua dengan berbagai efek samping yang memengaruhi kepatuhan berobat pasien. Oleh karena itu, pengobatan yang lebih singkat dengan lebih sedikit obat sangat dibutuhkan untuk mengatasi tantangan tersebut. Sejak tahun 2022, WHO telah mengumumkan pengobatan dengan paduan Bedaquiline, Pretomanid, Linezolid, dan Moksifloksasin (BPaL/M) untuk mengobati pasien TB-RO selama enam bulan.

Tujuan: Mengetahui karakteristik pasien TB-RO dan untuk mengetahui tingkat keberhasilan terapi pada pasien TB-RO yang mendapatkan pengobatan paduan BPaL/M di Rumah Sakit Umum Daerah Dr. H. Abdul Moeloek Provinsi Lampung. 

Metode: Penelitian dilakukan menggunakan metode observasional dengan penyajian analisis deskriptif.

Hasil: Karakteristik penderita tuberkulosis resisten obat terbanyak pada kelompok usia produktif yaitu rentang usia 20–44 tahun dengan jumlah 15 pasien atau sebesar 46%. Kelompok resisten primer dengan jumlah 19 pasien atau sebesar 58%. Karakteristik hasil uji kepekaan obat terbanyak pada kelompok resisten rifampicine dengan jumlah 21 pasien atau sebesar 64%. Median konversi sputum pada akhir pengobatan bulan ke-1, dengan tingkat keberhasilan terapi sebesar 83.9%.

Kesimpulan: Paduan BPaL/M menghasilkan konversi sputum yang cepat sehingga sangat efektif dan dapat menjadi pilihan terapi bagi pasien TB RR/MDR/pre-XDR pada fasilitas kesehatan di Indonesia.

Saran: Penelitian selanjutnya dapat membandingkan efektifitas terapi paduan BPaL/M, paduan pengobatan 9 bulan, dan paduan pengobatan jangka panjang dalam tingkat keberhasilan dan waktu konversi sputum.

 

Kata Kunci: Keberhasilan Terapi, Paduan BPaL/M, Tuberkulosis Resisten Obat.

 

ABSTRACT

 

Background: Tuberculosis (TB) is a preventable and usually curable disease. In 2023, tuberculosis causes an estimated 1.25 million deaths worldwide. Globally, there are an estimated 450,000 new cases of multi-drug resistant (MDR) tuberculosis or rifampicin resistant (RR) tuberculosis by 2021. Challenges in the treatment of drug-resistant tuberculosis (DR-TB) include a longer treatment period using second-line OAT with various side effects that affect patient treatment adherence. Therefore, shorter treatment with fewer drugs is needed to overcome these challenges. Since 2022, WHO has announced treatment with Bedaquiline, Pretomanid, Linezolid, and Moxifloxacin (BPaL/M) to treat drug-resistant tuberculosis (DR-TB) patients for six months.

Purpose: Knowing characteristics of DR-TB patients from 2024 to 2025 and to determine the efficacy of therapy in DR-TB patients who received BPaL/M treatment at Dr. H. Abdul Moeloek General Hospital, Lampung Province.

Method: This study was an observational research with descriptive analysis.

Result: The characteristics of DR-TB patients were mostly in the productive age group, range 20-44 years with a total of 15 patients or 46%. Primary resistant group with a total of 19 patients or 58%. The characteristics of drug sensitization test results were mostly in the rifampicine resistant group with a total of 21 patients or 64%. Median sputum conversion at the end of first month treatment, with the treatment success rate was 83.9%.

Conclusion: BPaL/M regimen has shown rapid sputum conversion, therefore leading to a highly effective treatment option for patients with RR/MDR/pre-XDR TB in health facilities in Indonesia.

Suggestions: Future studies might compare the effectiveness of BPaL/M regimen, 9-month regimen, and long-term regimen based on success rate and sputum conversion time.

 

Keywords: Efficacy of Therapy, BPaL/M Regimen, Drug Resistant Tuberculosis.

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