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Comparative Study
. 2000;2001(2):CD000970.
doi: 10.1002/14651858.CD000970.

Fully intermittent dosing with drugs for tuberculosis

H C Mwandumba  1 , S B Squire
Affiliations
Comparative Study

Fully intermittent dosing with drugs for tuberculosis

H C Mwandumba et al. Cochrane Database Syst Rev. 2000.

Update in

Abstract

Background: The number of people infected with tuberculosis continues to rise world-wide. 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 patients with pulmonary tuberculosis.

Search strategy: We searched the Cochrane Infectious Diseases Group trials register, the Cochrane Controlled Trials Register, Medline, and reference lists of articles. We contacted experts in the field.

Selection criteria: Randomised and quasi-randomised trials of any multi-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.

Reviewer's 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 randomised studies are required to establish the effectiveness of fully intermittent, short-course chemotherapy.

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Conflict of interest statement

We certify that we have no affiliations with or involvement in any organization or entity with a direct financial interest in the subject matter of the review (eg employment, consultancy, stock ownership, honoraria, expert testimony).

Figures

1.1
1.1. Analysis
Comparison 1 Thrice weekly tuberculosis treatment versus daily treatment, Outcome 1 Cure.
1.2
1.2. Analysis
Comparison 1 Thrice weekly tuberculosis treatment versus daily treatment, Outcome 2 Death.
1.3
1.3. Analysis
Comparison 1 Thrice weekly tuberculosis treatment versus daily treatment, Outcome 3 Recurrence.
1.4
1.4. Analysis
Comparison 1 Thrice weekly tuberculosis treatment versus daily treatment, Outcome 4 Resistance.
1.5
1.5. Analysis
Comparison 1 Thrice weekly tuberculosis treatment versus daily treatment, Outcome 5 Adherence.
1.6
1.6. Analysis
Comparison 1 Thrice weekly tuberculosis treatment versus daily treatment, Outcome 6 Toxicity.
See this image and copyright information in PMC

References

References to studies included in this review

Hong Kong 1981 {published data only}
    1. Hong Kong Chest Service/ British Medical Research Council. Controlled trial of four thrice weekly regimens and a daily regimen all given for 6 months for pulmonary tuberculosis. Lancet 1981;1:171‐4. - PubMed

References to studies excluded from this review

Brazil 1989 {published data only}
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Hong Kong 1974 {published data only}
    1. Hong Kong Tuberculosis Treatment Services/Brompton Hospital/British Medical Research Council. A controlled clinical trial of daily and intermittent regimens of rifampicin plus ethambutol in the retreatment of patients with pulmonary tuberculosis in Hong Kong. Tubercle 1974;55:1‐27. - PubMed
Hong Kong 1982 {published data only}
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Korea 1988 {published data only}
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South Africa 2000 {published data only}
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