Effect of Duration and Intermittency of Rifampin on Tuberculosis Treatment Outcomes A Systematic Review and Meta-Analysis 英文参考文献.docVIP

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Effect of Duration and Intermittency of Rifampin on Tuberculosis Treatment Outcomes A Systematic Review and Meta-Analysis 英文参考文献.doc

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Effect of Duration and Intermittency of Rifampin on Tuberculosis Treatment Outcomes A Systematic Review and Meta-Analysis 英文参考文献

EffectofDurationandIntermittencyofRifampinon TuberculosisTreatmentOutcomes:ASystematicReview andMeta-Analysis DickMenzies1*,AndreaBenedetti1,AnitaPaydar1,IanMartin1,SarahRoyce2,MadhukarPai1 ,Andrew Vernon3,ChristianLienhardt4,WilliamBurman5 1RespiratoryandEpidemiologyClinical ResearchUnit, MontrealChestInstitute DepartmentofEpidemiology,Biostatistics Occupational Health,McGillUniversity, Montreal,Canada,2UniversityofCaliforniaatSanFrancisco,SanFrancisco,California,UnitedStatesofAmerica,3CentersforDiseaseControlandPrevention,Atlanta, Georgia, United States of America, 4International Union against Tuberculosis and Lung Diseases, and Institut de Recherche pour le De′veloppement, Paris, France, 5DenverPublicHealth,Denver,Colorado,UnitedStatesofAmerica Abstract Background:Treatmentregimensforactivetuberculosis(TB)thatareintermittent,oruserifampinduringonlytheinitial phase,offerpracticaladvantages,buttheirefficacyhasbeenquestioned.Weconductedasystematicreviewoftreatment regimensforactiveTB,toassesstheeffectofdurationandintermittencyofrifampinuseonTBtreatmentoutcomes. Methods and Findings: PubMed, Embase, and the Cochrane CENTRAL database for clinical trials were searched for randomized controlled trials, published in English, French, or Spanish, between 1965 and June 2008. Selected studies utilized standardized treatment with rifampin-containing regimens. Studies reported bacteriologically confirmed failure and/or relapse in previously untreated patients with bacteriologically confirmed pulmonary TB. Pooled cumulative incidences oftreatment outcomes andassociation withrisk factors werecomputed withstratified randomeffects meta- analyses.Meta-regressionwasperformedusinganegativebinomialregressionmodel.Atotalof57trialswith312armsand 21,472 participants were included in the analysis. Regimens utilizing rifampin only for the first 1–2mo had significantly higherratesoffailure,relapse,andacquireddrugresistance,ascomparedtoregimensthatusedrifampinfor6mo.Thiswas particular