Rationality of Anti-Tuberculosis Drug (OAT) Use in Pulmonary Tuberculosis Patients at Kediri District Hospital in 2025

Ardianta Rabu, Juli 08, 2026
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FORMOSA NEWS

Hospital Review Finds High Compliance with Tuberculosis Treatment Guidelines in Kediri

Tuberculosis treatment at Kediri District Hospital, Indonesia, largely follows Indonesia's national treatment guidelines, according to a study published in 2026 by Arifani Siswidiasari, Elly Megasari, Tri Doso Sapto Agus Priyono, and Neni Probosiwi from the Faculty of Health Sciences, Kadiri University, Kediri, Indonesia. The research found that nearly all anti-tuberculosis drug prescriptions met national standards for patient selection, diagnosis, medication choice, dosage, treatment duration, and administration. The findings highlight the importance of rational drug use in preventing drug resistance, improving treatment success, and supporting Indonesia's tuberculosis control efforts.

Why Rational Tuberculosis Treatment Matters

Tuberculosis (TB) remains one of the world's deadliest infectious diseases and continues to pose a major public health challenge in Indonesia. The disease, caused by Mycobacterium tuberculosis, primarily attacks the lungs and spreads through airborne transmission.

Indonesia consistently ranks among countries with the highest tuberculosis burden globally. According to national health surveys cited in the study, more than 877,000 TB cases were reported nationwide in 2023, with East Java Province recording over 130,000 cases, making it one of the country's most affected regions.

Effective TB treatment requires patients to receive the correct combination of antibiotics at the right dosage and for the appropriate duration. Even small prescribing errors or interrupted treatment can increase the risk of treatment failure and contribute to multidrug-resistant tuberculosis (MDR-TB), a growing global health concern.

Against this backdrop, researchers from Kadiri University evaluated how closely physicians at Kediri District Hospital adhered to Indonesia's National Guidelines for Tuberculosis Management when prescribing anti-tuberculosis drugs (OAT).

How the Study Was Conducted

The researchers performed a retrospective observational study using hospital medical records from pulmonary tuberculosis patients treated at Kediri District Hospital during 2025.

The study analyzed data from 62 adult patients whose medical records met predefined inclusion criteria. Patient records were reviewed to assess whether anti-tuberculosis drug therapy complied with six indicators of rational drug use established by Indonesia's national treatment guidelines:

  • Appropriate patient
  • Appropriate indication
  • Appropriate drug selection
  • Appropriate dosage
  • Appropriate treatment duration
  • Appropriate route of administration

Rather than testing a new treatment, the researchers evaluated the quality and appropriateness of routine clinical practice using descriptive statistical analysis.

Patient Characteristics

Among the 62 patients included in the study:

  • 62.9% were male.
  • The largest age group was 46–55 years (32.26%).
  • 38.71% had completed junior high school.
  • 32.26% were self-employed.
  • 58.06% had diabetes mellitus as a comorbid condition.
  • 85.48% were undergoing intensive first-line tuberculosis treatment.

The high proportion of patients with diabetes reflects a growing clinical challenge because diabetes is known to increase susceptibility to active tuberculosis and may complicate treatment outcomes.

Key Findings

The evaluation demonstrated very high adherence to national tuberculosis treatment standards.

The study reported the following compliance rates:

  • Correct patient selection: 100%
  • Correct clinical indication: 100%
  • Correct medication administration: 100%
  • Correct treatment duration: 98.39%
  • Correct drug selection: 96.77%
  • Correct dosage: 95.16%

These results indicate that physicians at Kediri District Hospital generally prescribed anti-tuberculosis medications appropriately according to national clinical guidelines.

However, the researchers also identified several prescribing issues.

Three patients received dosages that did not fully match recommendations based on body weight and treatment category. Two patients received drug regimens that differed from guideline recommendations, while one patient experienced an interruption in treatment duration that categorized the individual as a treatment dropout.

Although these cases represented only a small proportion of patients, they demonstrate that continuous monitoring remains essential to ensure complete compliance with treatment standards.

Why Rational Drug Use Is Critical

Appropriate use of anti-tuberculosis drugs is essential for both individual patients and public health.

Incorrect drug selection, underdosing, overdosing, or premature discontinuation of therapy can:

  • Increase treatment failure
  • Promote antibiotic resistance
  • Raise the risk of disease relapse
  • Increase tuberculosis transmission within communities
  • Lead to more complex and costly treatment

The World Health Organization (WHO) has long emphasized rational prescribing as a cornerstone of successful tuberculosis control through the Directly Observed Treatment, Short-course (DOTS) strategy.

The Kediri study suggests that adherence to standardized prescribing practices can help maintain treatment effectiveness while reducing the likelihood of drug-resistant tuberculosis.

Implications for Healthcare and Policy

The findings provide encouraging evidence that national tuberculosis treatment guidelines are being implemented effectively at Kediri District Hospital.

For healthcare providers, the results reinforce the importance of regular prescription audits and adherence to evidence-based clinical protocols.

For hospital administrators, the study demonstrates that routine monitoring of prescribing quality can identify small gaps before they become larger patient safety concerns.

For policymakers, the research supports continued investment in standardized TB treatment programs, clinician training, and surveillance systems that monitor treatment quality across healthcare facilities.

The study also highlights the importance of integrating tuberculosis care with diabetes management, given the large proportion of patients diagnosed with both conditions.

As Indonesia continues efforts to eliminate tuberculosis, maintaining rational drug use will remain a critical strategy for preventing multidrug-resistant TB while improving patient outcomes.

Academic Insight

The authors from Kadiri University conclude that anti-tuberculosis drug prescribing at Kediri District Hospital generally complies with Indonesia's National Guidelines for Tuberculosis Management. Their findings indicate that high levels of prescribing accuracy contribute to effective tuberculosis treatment while helping reduce the risks of therapeutic failure, adverse drug effects, and antimicrobial resistance.

Author Profile

Arifani Siswidiasari, S.Farm., Apt. is a researcher and lecturer in the Pharmacist Professional Study Program, Faculty of Health Sciences, Kadiri University, Kediri, Indonesia. Her research focuses on clinical pharmacy, rational drug use, pharmaceutical care, and medication evaluation, particularly in infectious disease management. She collaborated with Elly Megasari, Tri Doso Sapto Agus Priyono, and Neni Probosiwi, who are also affiliated with the Faculty of Health Sciences at Kadiri University and specialize in pharmacy education and clinical pharmaceutical sciences.

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