Chinese herbal medicine as adjuvant treatment to chemotherapy for multidrug-resistant tuberculosis (MDR-TB): A systematic review of randomised clinical trials

Tuberculosis ◽  
2015 ◽  
Vol 95 (4) ◽  
pp. 364-372 ◽  
Author(s):  
Mei Wang ◽  
Xin Guan ◽  
Yuan Chi ◽  
Nicola Robinson ◽  
Jian-Ping Liu
2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Solomon Weldegebreal Asgedom ◽  
Mebrahtu Teweldemedhin ◽  
Hailay Gebreyesus

Background. Multidrug-resistant tuberculosis (MDR-TB) has continued to be a challenge for tuberculosis (TB) control globally. Ethiopia is one of the countries with high MDR-TB burden. Objective. The main purpose of this study was to determine the prevalence of MDR-TB and associated factors in Ethiopia. Methods. A systematic review of the literatures on prevalence of MDR-TB and associated factors was conducted in the country. Results. In our electronic search, 546 citations were depicted. Among the total 546 citations described, a total of 22 articles met eligibility criteria and were included in the review article. According to our review, the prevalence of MDR-TB ranged from 0 to 46.3%. The average mean rate of MDR-TB in Ethiopia was found to be 12.6±15.9%. The overall prevalence of MDR-TB in all TB cases was estimated to be 1.4%. From a total of 3849 patients studied, 527 had MDR-TB. Previous exposure to antituberculosis treatment was the most commonly identified risk factor of MDR-TB in Ethiopia. Conclusion. Despite relative decline in incidence of MDR-TB, the distribution and prevalence of MDR-TB continued to be a serious challenge for TB control in Ethiopia. Previous exposure to antituberculosis treatment was also the most common risk factor for MDR-TB. Therefore, strong TB and MDR-TB treatment along with tight introduction of follow-up strategies should be applied for better TB control.


2017 ◽  
Vol 49 (3) ◽  
pp. 1600803 ◽  
Author(s):  
Mayara Lisboa Bastos ◽  
Zhiyi Lan ◽  
Dick Menzies

This systematic review aimed to update the current evidence for multidrug-resistant tuberculosis (MDR-TB) treatment.We searched for studies that reported treatment information and clinical characteristics for at least 25 patients with microbiologically confirmed pulmonary MDR-TB and either end of treatment outcomes, 6-month culture conversion or severe adverse events (SAEs). We assessed the association of these outcomes with patients' characteristics or treatment parameters. We identified 74 studies, including 17 494 participants.The pooled treatment success was 26% in extensively drug-resistant TB (XDR-TB) patients and 60% in MDR-TB patients. Treatment parameters such as number or duration and individual drugs were not associated with improved 6-month sputum culture conversion or end of treatment outcomes. However, MDR-TB patients that received individualised regimens had higher success than patients who received standardised regimens (64% versus 52%; p<0.0.01). When reports from 20 cohorts were pooled, proportions of SAE ranged from 0.5% attributed to ethambutol to 12.2% attributed to para-aminosalicylic acid. The lack of significant associations of treatment outcomes with specific drugs or regimens may reflect the limitations of pooling the data rather than a true lack of differences in efficacy of regimens or individual drugs.This analysis highlights the need for stronger evidence for treatment of MDR-TB from better-designed and reported studies.


BMJ Open ◽  
2016 ◽  
Vol 6 (1) ◽  
pp. e008973 ◽  
Author(s):  
Wenming Zhang ◽  
Shangquan Wang ◽  
Ranxing Zhang ◽  
Yuanyuan Zhang ◽  
Xinjian Li ◽  
...  

2014 ◽  
Vol 58 (4) ◽  
pp. 2316-2321 ◽  
Author(s):  
Jean-Philippe Lanoix ◽  
Fabrice Betoudji ◽  
Eric Nuermberger

ABSTRACTPreventing the development of tuberculosis (TB) in contacts of patients with multidrug-resistant TB (MDR-TB) by the treatment of latent TB infection (LTBI) is highly desirable. However, few safe, well tolerated, and effective drugs are available to treat MDR-LTBI and the published guidance is limited. Fortunately, six new chemical entities from four classes developed to treat TB have entered clinical trials in the past decade. We tested three of these drugs alone and in combination in an experimental paucibacillary LTBI chemotherapy model using BALB/c and C3HeB/FeJ mice immunized with a recombinant strain ofMycobacterium bovisbacillus Calmette-Guérin (rBCG30) and then challenged with a low-dose aerosol ofM. tuberculosisH37Rv. The regimens tested contained bedaquiline (TMC), PA-824 (Pa), sutezolid (PNU), and/or one of two fluoroquinolones. Control mice received rifampin (RIF) or isoniazid (INH). In BALB/c mice, TMC-containing regimens and the Pa-PNU combination were the most active test regimens and were at least as effective as RIF. Pa, PNU, and levofloxacin had activity comparable to that of INH. Virtually identical results were observed in C3HeB/FeJ mice. This study confirms the potent activity of TMC observed previously in BALB/c mice and highlights Pa alone or in combination with either PNU or a fluoroquinolone as a regimen worthy of evaluation in future clinical trials of MDR-LTBI. Given their closer pathological representation of human TB lesions, C3HeB/FeJ mice may become a preferred model for the experimental chemotherapy of LTBI. Future studies should evaluate additional clinically relevant LTBI regimens in this strain including relapse as an endpoint.


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