Effectiveness and safety of tuberculosis preventive treatment for contacts of patients with multidrug-resistant tuberculosis: a systematic review and meta-analysis

作者：Guozhong Zhou, Shiqi Luo, Jian He, Nan Chen, Yu Zhang, Shunli Cai, Xin Guo, Hongbo Chen, Chao Song · 发表于：Clinical Microbiology and Infection · 年份：2023 · DOI：10.1016/j.cmi.2023.09.015 · 被引用次数：16 · 研究领域：Tuberculosis Research and Epidemiology、Pneumonia and Respiratory Infections、Infectious Diseases and Tuberculosis

BACKGROUND: Contacts of patients with multidrug-resistant tuberculosis (MDR-TB) are at risk of developing TB disease. Tuberculosis preventive treatment (TPT) is an intervention that can potentially reduce this risk. OBJECTIVES: To evaluate the effectiveness and safety of TPT for contacts of patients with MDR-TB. DATA SOURCES: EMBASE, PubMed, Web of Science, and the Cochrane Library were searched for eligible studies on 24 July 2023, without start date restrictions. STUDY ELIGIBILITY CRITERIA: We included studies that compared TPT with no treatment in contacts of patients with MDR-TB and reported outcomes of progression to TB disease. PARTICIPANTS: Contacts of patients with MDR-TB. INTERVENTIONS: TPT. ASSESSMENT OF RISK OF BIAS: A modified version of the Newcastle-Ottawa Scale was used. METHODS OF DATA SYNTHESIS: Random-effects meta-analysis was utilized to calculate the relative risk for disease progression to TB in contacts of patients with MDR-TB who received TPT compared to those who did not. Additionally, completion, adverse effect, and discontinued rates were assessed. RESULTS: Involving 1105 individuals from 11 studies, the pooled relative risk for disease progression in contacts receiving TPT versus those without treatment was 0.34 (95% CI: 0.16-0.72). Subgroup analysis indicated a lower pooled relative risk for regimens based on the drug-resistance profile of the index patients with TB compared to uniform treatment regimens (0.22 [95% CI: 0.06-0.84] vs. 0.49 [95% CI: ...