Efficacy and safety of a four-drug fixed-dose combination regimen versus separate drugs for treatment of pulmonary tuberculosis: a systematic review and meta-analysis
Braz. j. microbiol
; 48(2): 198-207, April.-June 2017. tab, graf
Artículo
en Inglés
| LILACS
| ID: biblio-839364
Biblioteca responsable:
BR1.1
ABSTRACT
Abstract Introduction:
Tuberculosis, particularly multi-drug-resistant tuberculosis, is a major cause of morbidity and mortality worldwide. To the best of our knowledge, however, no study to date has assessed the combined use of the four available drugs for tuberculosis treatment, which is an issue of great clinical relevance.Objective:
To determine whether the four-drug fixed-dose combination is safer or more effective than separate drugs for treatment of pulmonary tuberculosis.Methods:
A systematic review of the literature was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Results:
In pooled results from five randomized controlled trials with 3502 patients across Africa, Asia, and Latin America, four-drug fixed-dose combination therapy was no better than separate drugs therapy in terms of culture conversion after 2 and 6 months of treatment. There were no significant differences between the groups in overall incidence of adverse effects. However, the meta-analytic measure (log odds ratio) revealed that separate drugs treatment had a 1.65 [exp (0.5) = 1.65] increased chance of gastrointestinal adverse effects compared to four-drug fixed-dose combination treatment.Conclusions:
The reviewed studies showed that four-drug fixed-dose combination therapy provides greater patient comfort by reducing the number of pills and the incidence of gastrointestinal adverse effects, as well as simplifying pharmaceutical management at all levels.
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Contexto en salud:
ODS3 - Salud y Bienestar
/
Enfermedades Desatendidas
/
ODS3 - Meta 3.3 Poner fin a las enfermedades desatendidas y detener enfermedades transmisibles
/
ODS3 - Meta 3.4 Reducir las muertes prematuras por enfermedades no transmisibles
Problema de salud:
Meta 3.3: Poner fin a las enfermedades desatendidas y detener enfermedades transmisibles
/
Enfermedades Desatendidas
/
Tuberculosis
/
Tuberculosis
/
Otras Enfermedades Respiratorias
Base de datos:
LILACS
Asunto principal:
Tuberculosis Pulmonar
/
Antituberculosos
Tipo de estudio:
Ensayo clínico controlado
/
Guía de práctica clínica
/
Revisión sistemática
Límite:
Humanos
País/Región como asunto:
Africa
Idioma:
Inglés
Revista:
Braz. j. microbiol
Asunto de la revista:
Microbiologia
Año:
2017
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
Laboratório Central de Saúde Pública/BR