Mahardani Putu Nandika, Wati Dyah Kanya, Siloam Azriel, Savitri Ni Putu Ayu, Manggala Arya Krisna
School of Medicine, Faculty of Medicine, Udayana University, Bali, Indonesia.
Pediatric Emergency and Intensive Care Sanglah Public Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia.
Oman Med J. 2022 Jan 31;37(1):e337. doi: 10.5001/omj.2021.64. eCollection 2022 Jan.
This systematic review explores the effectiveness and safety of a short-term regimen (STR) in treating multidrug-resistant tuberculosis (MDR-TB). We use several cohort studies which were searched using standardized Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The keywords were used based on problem, intervention, comparison, and outcome consisted of MDR-TB and STR. Seven cohort studies were selected from 314 studies. The result showed that STR has better therapeutic efficacy and shorter duration than the 2011 World Health Organization regimen for MDR-TB with success rates above 50% in respective studies. The most effective regimen was kanamycin-high-dose isoniazid-clofazimine-ethambutol-prothionamide-pyrazinamide-gatifloxacin in the intensive phase for four months and clofazimine-ethambutol-pyrazinamide-gatifloxacin-prothionamide in the continuation phase for eight months. Gastrointestinal problems, ototoxicity, dysglycemia, and liver problems were the most reported side effects. STR provides good effectiveness in MDR-TB treatment in terms of treatment success rate and short therapy duration.
本系统评价探讨了短期治疗方案（STR）治疗耐多药结核病（MDR-TB）的有效性和安全性。我们使用了多项队列研究，这些研究是通过标准化的系统评价和Meta分析首选报告项目进行检索的。基于问题、干预措施、对照和结局使用的关键词包括耐多药结核病和短期治疗方案。从314项研究中筛选出7项队列研究。结果表明，与2011年世界卫生组织的耐多药结核病治疗方案相比，短期治疗方案具有更好的治疗效果和更短的疗程，各研究中的成功率均超过50%。最有效的方案是强化期4个月使用卡那霉素-高剂量异烟肼-氯法齐明-乙胺丁醇-丙硫异烟胺-吡嗪酰胺-加替沙星，继续期8个月使用氯法齐明-乙胺丁醇-吡嗪酰胺-加替沙星-丙硫异烟胺。胃肠道问题、耳毒性、血糖异常和肝脏问题是报告最多的副作用。就治疗成功率和短疗程而言，短期治疗方案在耐多药结核病治疗中具有良好的有效性。
