Corticosteroids for Prevention of Mortality in People with Tuberculosis: A Systematic Review
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Keywords
Tuberculosis, corticosteroids, drug resistant, systematic review
Abstract
corticosteroids have systemic effects, their beneficial impacts on tuberculosis are believed to be organ specific. A worldwide health concern, tuberculosis has become more convoluted due to the enhanced occurrence of drug-resistant strains & its persistence in aging populations.
Aim and objective: The purpose of this investigation was to assess the effect of adjunctive corticosteroids on mortality in people with tuberculosis.
Patients and methods: All relevant randomized controlled trials or quasi-randomized controlled trials involving individuals with any clinically or microbiologically defined form of tuberculosis are involved in this systematic review. cases older than fourteen years. A corticosteroid of any dosage, period, or route of administration could constitute the intervention. The search was conducted using several electronic databases, which include all dates as of its creation: Literatura Latinoamericana e do Caribe em Ciências da Saúde (LILACS), the Cochrane infectious illnesses group investigation register, the Cochrane Central Register of controlled studies, Medline (accessed via PubMed), & Embase.
Conclusion: Researchers have found that steroids reduce the death rates among tuberculosis cases. Nevertheless, the precise function of corticosteroids in pulmonary tuberculosis, especially in situations of severe illness, is still unclear. To resolve this uncertainty, additional large prospective controlled studies with sufficient ability to identify alterations to these outcomes are required.
References
2. Bisson GP, Bastos M, Campbell JR, Bang D, Brust JC, Isaakidis P, et al. Mortality in adults with multidrug-resistant tuberculosis and HIV by antiretroviral therapy and tuberculosis drug use: an individual patient data meta-analysis. Lancet. 2020;396(10248):402–11.
3. Anaghashree US. Outcome of Patients with Extrapulmonary Tuberculosis on Treatment with Anti Tubercular Therapy. Rajiv Gandhi University of Health Sciences (India); 2019.
4. Qian X, Nguyen DT, Lyu J, Albers AE, Bi X, Graviss EA. Risk factors for extrapulmonary dissemination of tuberculosis and associated mortality during treatment for extrapulmonary tuberculosis. Emerg Microbes Infect. 2018;7(1):1–14.
5. Jang JG, Chung JH. Diagnosis and treatment of multidrug-resistant tuberculosis. Yeungnam Univ J Med. 2020;37(4):277.
6. Smego RA, Ahmed N. A systematic review of the adjunctive use of systemic corticosteroids for pulmonary tuberculosis. Int J Tuberc Lung Dis. 2003;7(3):208–13.
7. Thwaites GE, Bang ND, Dung NH, Quy HT, Oanh DTT, Thoa NTC, et al. Dexamethasone for the treatment of tuberculous meningitis in adolescents and adults. N Engl J Med. 2004;351(17):1741–51.
8. Kim YJ, Pack KM, Jeong E, Na JO, Oh YM, Lee SD, et al. Pulmonary tuberculosis with acute respiratory failure. Eur Respir J. 2008;32(6):1625–30.
9. Yang JY, Han M, Koh Y, Kim WS, Song JW, Oh YM, et al. Effects of corticosteroids on critically ill pulmonary tuberculosis patients with acute respiratory failure: a propensity analysis of mortality. Clin Infect Dis. 2016;63(11):1449–55.
10. Viarasilpa T, Tongyoo S, Permpikul C. Effect of adjunctive corticosteroid therapy on outcomes in pulmonary tuberculosis patients with acute respiratory failure: a cohort study: Steroid in tuberculosis respiratory failure. Clin Crit Care. 2021;29.
11. Lemos CX, Anton C, Machado FD, Bernardi RM, Freitas AA, Silva DR. Adjunctive corticosteroid therapy in patients with pulmonary tuberculosis. Rev Assoc Med Bras. 2022;68:1199–203.
12. Ali MK, Karanja S, Karama M. Factors associated with tuberculosis treatment outcomes among tuberculosis patients attending tuberculosis treatment centres in 2016-2017 in Mogadishu, Somalia. Pan Afr Med J. 2017;28(1).
13. Chakaya J, Khan M, Ntoumi F, Aklillu E, Fatima R, Mwaba P, et al. Global Tuberculosis Report 2020–Reflections on the Global TB burden, treatment and prevention efforts. Int J Infect Dis. 2021;113:S7–12.
14. Schutz C, Davis AG, Sossen B, Lai RPJ, Ntsekhe M, Harley YXR, et al. Corticosteroids as an adjunct to tuberculosis therapy. Expert Rev Respir Med. 2018;12(10):881–91.
15. Singh SK, Tiwari KK. Use of corticosteroids in tuberculosis. J Assoc Chest Physicians. 2017;5(2):70–5.
16. Wunderink RG. Corticosteroids for severe community-acquired pneumonia: not for everyone. Jama. 2015;313(7):673–4.
17. Cheung CMG, Chee SP. Jarisch–Herxheimer reaction: paradoxical worsening of tuberculosis chorioretinitis following initiation of antituberculous therapy. Eye. 2009;23(6):1472–3.
18. Wallis RS. Reconsidering adjuvant immunotherapy for tuberculosis. Clin Infect Dis. 2005;41(2):201–8.
19. Meduri GU, Golden E, Freire AX, Taylor E, Zaman M, Carson SJ, et al. Methylprednisolone infusion in early severe ARDS: results of a randomized controlled trial. Chest. 2007;131(4):954–63.
20. Dooley DP, Carpenter JL, Rademacher S. Adjunctive corticosteroid therapy for tuberculosis: a critical reappraisal of the literature. Clin Infect Dis. 1997;25(4):872–87.
21. Zahar JR, Azoulay E, Klement E, De Lassence A, Lucet JC, Regnier B, et al. Delayed treatment contributes to mortality in ICU patients with severe active pulmonary tuberculosis and acute respiratory failure. Intensive Care Med. 2001;27:513–20.
22. Critchley JA, Young F, Orton L, Garner P. Corticosteroids for prevention of mortality in people with tuberculosis: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13(3):223–37.
23. Muthu V, Agarwal R, Dhooria S, Aggarwal AN, Behera D, Sehgal IS. Outcome of critically ill subjects with tuberculosis: systematic review and meta-analysis. Respir Care. 2018;63(12):1541–54.
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