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Evidence summaries

Length of Tuberculosis Chemotherapy

Short (6 months) chemotherapy for tuberculosis may be as effective as 8-9 months of chemotherapy. Level of evidence: "C"

Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment in 2 trials, no blinding in 2 trials) and by imprecise results (wide confidence intervals). .

A topic in Clinical Evidence 1 summarizes the results of 2 RCTs on the chemotherapy of tuberculosis including a total of 1295 subjects and comparing regimens of 6 months with regimens of 8-9 months. Participants were followed up for at least one year after treatment was completed. Both RCTs found no significant difference in relapse rates (p > 0.1) between short and longer regimens.

A Cochrane review[Abstract]2 included 3 studies with a total of 328 subjects comparing six-month regimens with nine-month regimens to treat adults with intestinal and peritoneal tuberculosis in Asia. Regimens were based on isoniazid, rifampicin, pyrazinamide, and ethambutol. The median duration of follow-up after completion of treatment was between 12 and 39 months. Relapse was uncommon (2/140 with 6-month vs 0/129 in 9-month group; RR 2.78, 95% CI 0.29 to 26.33; 3 trials, n= 282; low quality evidence). At the end of therapy, there was no difference in clinical cure between 6- and 9-month regimens (RR 1.02, 95% CI 0.97 to 1.08; 3 trials, n=294 participants; moderate quality evidence).

References

  • Garner P, Holmes A, Ziganshina L. What are the effects of different drug regimens in people with newly diagnosed pulmonary tuberculosis? Clinical Evidence 2005;13:1039-1040.
  • Jullien S, Jain S, Ryan H et al. Six-month therapy for abdominal tuberculosis. Cochrane Database Syst Rev 2016;(11):CD012163. [PubMed]

Primary/Secondary Keywords