PERALIHAN (KONVERSI) SPUTUM BTA ANTARA PEMBERIAN DOSIS BAKU (STANDAR) DAN TINGGI RIFAMPICIN PADA PENGOBATAN (TERAPI) ANTI TUBERKULOSIS KELOMPOK (KATEGORI) I

Abstract

Acid fast bacilli (AFB) sputum microscopy is used as a diagnostic tool of pulmonary tuberculosis (TB) in TB eradication program
with directly observed treatment short course (DOTS) strategy. The AFB sputum microscopy should be performed before treatment,
two months after intensive phase and four months after advance phase treatment. This study is a part of a research to compare the
standard (450 mg) and high (600 mg) rifampicin dose in patients with pulmonary tuberculosis in Indonesia. The aim of this study
was to detect the sputum conversion time of AFB in pulmonary TB patients who obtained category I antituberculous treatment with
standard dose compared to one who received high dose of rifampicin at the beginning and at the end of the intensive phase. This AFB
sputum microscopy have been performed from September 2003 until August 2005 from 85 pulmonary TB patients every two weeks
using Ziehl Neelsen and read by means of International Union Against Tuberculosis and Lung Diseases (IUATLD) scale, in Poliklinik
Paru Balai Pengobatan Penyakit Paru-paru and Department of Internal Medicine RS. Dr. Hasan Sadikin. Patients with pulmonary TB
who obtained category I antituberculous treatment of the intensive phase were divided randomly double blind into two groups, using
statistical analysis by Page test for order alternative and Mann Whitney test. After randomization, there were 52 patients who received
standard dose and 33 patients who had high dose of rifampicin. Sputum conversions of AFB on week 2, 4, 6, and 8 were 36.1%, 63.9%,
75%, and 91.7% for standard dose group. Sputum conversions of AFB on week 2, 4, 6, and 8 were 46.2%, 80.8%, 80.8%, and 84.6%
for high dose group. Sputum conversion of AFB for high dose group were faster than standard dose group (p=0.030). Dropout (DO)
patients were 5.9% (5/85) and no sputum conversion of AFB on week 8 was 8.3% and 15.4% for standard dose group and high dose
group of rifampicin, respectively. Sputum conversions of AFB for high dose group were found significant more quickly than standard
dose group of rifampicin statistically.