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In the absence of guidance from public health bodies, it could be argued that third-party representatives from the pharmaceutical industry may have contributed to the high usage of second line and third line agents [ 30].
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While some believe that they will probably reduce the usage of first-line treatments the long-term safety of interferons and glatiramer acetate will probably slow this trend.
Longer overall survival was associated with a number of factors such as usage of second-line therapy and an initial dose reduction.
The limited private sector usage of most second line drugs may be slowing the emergence of additional second line drug resistance, although the finding of significant fluoroquinolone usage for both TB and non-TB indications is consistent with the increasing incidence of fluoroquinolone-resistant TB in certain countries [31].
The observed reduction in usage and cost of first-line drugs for patients referred to AIC was consistent and significant.
Of the nine low frequency codons identified in the first line, five were shifted to higher usage frequencies (second line); I141 and Y151 are among these.
Furthermore, a recent physician-based survey of first-line treatment for advanced CRC revealed that 30% of patients worldwide still receive fluoropyrimidine monotherapy (Capecitabine Usage Tracking Study. The Research Partnership, 2004).
A number of surveys point to rising usage of second screen devices while watching TV.
However, they were insufficient to provide reliable TB usage estimates for a number of the second line drugs in countries with less private sector TB treatment.
Significant fluoroquinolone usage for TB does exist in several countries, although given the much smaller volumes of other second line agents, the fluoroquinolones are likely being used as monotherapy or as an add-on to first-line therapy rather than as part of a designated second-line therapy.
The modern, exclusively ironic usage of "first world problems" did not get going until the mid-1990s.
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