Fully intermittent dosing with drugs for treating tuberculosis in adults

  • Review
  • Intervention

Authors


Abstract

Background

The number of people infected with tuberculosis continues to rise worldwide. Rifampicin-containing treatment regimens can achieve high cure rates. Intermittent drug treatment delivered in the community has the potential to improve adherence to treatment.

Objectives

The objective of this review was to compare the effectiveness of rifampicin-containing short-course chemotherapy regimens, given two or three times a week, with similar regimens given daily in adult patients with pulmonary tuberculosis.

Search methods

We searched the Cochrane Infectious Diseases Group specialized trials register (January 2003), The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2002), MEDLINE (1966 to January 2003), EMBASE (1980 to December 2002), and reference lists of articles. We contacted experts in the field.

Selection criteria

Randomized and quasi-randomized trials of any multiple drug regimen containing rifampicin in patients with confirmed pulmonary tuberculosis. Treatment had to be given up to three times a week for up to nine months, with any initial daily dosing period not more than one month, and was compared to daily dosing throughout for the same period.

Data collection and analysis

Two reviewers independently assessed trial eligibility and quality.

Main results

One trial involving 399 patients was included. The trial compared treatment three times per week with daily treatment for six months. There was no difference in cure rate (198 out of 199 people in the intermittent group compared to all 200 in the daily group), but 5 patients relapsed in the group receiving intermittent therapy compared to one in the group receiving the daily regimen.

Authors' conclusions

There is not enough evidence to assess the equivalence of effect between fully intermittent, rifampicin-containing short-course chemotherapy and similar daily therapy in patients with pulmonary tuberculosis. Larger randomized studies are required to establish the equivalence of fully intermittent, short-course chemotherapy, with daily regimens.

摘要

背景

以完全間歇性給藥用於治療成人肺結核

全球感染肺結核之人數仍持續增加。含有rifampicin之處方可達成高治癒率。在社區內進行之間歇性藥物治療具有改善治療遵從性之潛力。

目標

本回顧之目的係比較每週給予2或3次含有rifampicin的短期化療療程與每日給予的類似療程對於成人肺結核之有效性。

搜尋策略

我們搜尋Cochrane Infectious Diseases Group specialized trials register (2003年1月)、Cochrane Central Register of Controlled Trials (Cochrane Library Issue 4, 2002)、MEDLINE(1966年 – 2003年1月)、EMBASE (1980年−2002年12月),以及文章的參考資料清單,我們並聯絡本領域專家。

選擇標準

針對確診肺結核病患之含rifampicin的任何多劑藥物療程之隨機及半隨機對照試驗。治療必須為每週給予最多3次,持續達最多9個月,且其任何起始每日投藥期不超過1個月,並與相同期間之每日投藥比較。

資料收集與分析

由2位回顧作者獨立評估試驗適用性及品質。

主要結論

共收錄涉及399名病患之1項試驗。該試驗針對6個月中之每週治療3次與每天治療進行比較。其治癒率並無差異(間歇組199名病患中之198名相對於每日組之全部200名病患),但在間歇療法組中共有5名病患產生復發,而每日療程組中僅有1名產生復發。

作者結論

茲無足夠之證據得以評估,對於肺結核病患而言,含有rifampicin之完全間歇性短期化療與類似之每日治療是否具有相同效應。仍需要較大型之隨機研究,以建立完全間歇性之短期化療與每日療程間的等效性。

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

茲無足夠之證據得以比較完全間歇性治療與每日治療對於成人肺結核病患的等效性。當給予6個月時,含有rifampicin之藥物組合可對肺結核病患達成高治癒率。此種治療可自一開始即以每日或間歇(如,每週3次)方式給予。本回顧比較了此等治療給予方式之等效性,但並未發現足夠證據得以進行評估。

Plain language summary

There is insufficient evidence to compare equivalence of effect between fully intermittent and daily treatment in adult patients with pulmonary tuberculosis.

Rifampicin-containing drug combinations can achieve high cure rates in patients with pulmonary tuberculosis when given for six months. Such treatment can be given either daily or intermittently (eg three times a week) from the beginning. This review compared the equivalence of effect between such treatments but did not find enough evidence to be able to assess this.

Ancillary