EFIKASI, KEAMANAN, EFISIENSI BIAYA PENGGUNAAN REJIMEN BEDAQUILIN, PRETOMANID, DAN LINEZOLID (BPaL) DALAM PENGOBATAN TUBERKULOSIS RESISTEN OBAT GANDA
Keywords:
Tuberkulosis, rejimen BPaL, efektifitasAbstract
Kejadian tuberkulosis resisten obat ganda (TB-ROG) merupakan salah satu faktor utama kegagalan dalam penanganan tuberkulosis (TB). Pada tahun 2020 terdapat pedoman baru pengobatan TB-ROG yang menggunakan rejimen bedaquilin, pretomanid, dan linezolid (BPaL). Rejimen tersebut memiliki komposisi obat yang lebih sederhana dan lebih singkat. Namun, informasi mengenai efikasi, keamanan dan efisiensi biaya belum banyak tersosialisasikan secara luas. Tujuan dari review naratif ini adalah untuk mendeskripsikan efikasi, keamanan, dan efisiensi biaya pemberian rejimen BPaL pada pengobatan TB-ROG yang dapat bermanfaat untuk strategi pengobatan pada pasien TB-ROG. Studi review naratif ini dilakukan dengan mengacu pada berbagai referensi yang terfokus pada penggunaan rejimen BPaL. Mesin pencarian yang digunakan dalam pencarian literatur antara lain pubmed dan google scholar pada periode 2018-2023. Berdasarkan penelusuran, diperoleh 5 artikel yang disertakan dalam tinjauan naratif ini. Penggunaan rejimen BPaL dengan atau tanpa variasi dosis dan lama pemberian obat linezolid pada pengobatan TB-ROG, memiliki keberhasilan pengobatannya yang tinggi dengan efektifitas sebesar 84 – 93 %. Reaksi obat yang tidak dikehendaki telah dilaporkan setelah penggunaan rejimen BPaL. Beberapa diantaranya terkait dengan penggunaan linezolid, yaitu kajadian neuropati perifer, myelosupresi, neuritis optik, dan lainnya terkait dengan penggunaan bedaquilin dan pretomanid, yaitu kejadian perpanjangan interval QT jantung dan hepatotoksisitas. Studi mengenai efisiensi biaya pengobatan menunjukan penggunaan rejimen BPaL hasilnya jauh lebih murah 57% dibandingkan dengan rejimen konvensional. Studi ini menyimpulkan bahwa rejimen BPaL memberikan keberhasilan pengobatan selama 26 minggu dengan beberapa kejadian ROTD yang perlu diperhatikan. Selain itu, rejimen BPaL dapat menekan pembiayaan pengobatan langsung dibandingkan rejimen konvensional.References
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