Adjunctive steroid therapy for managing pulmonary tuberculosis

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Corticosteroids did not reduce mortality from pulmonary tuberculosis.

While tuberculosis is curable with standardized treatment, outcomes for some forms are improved with adjunctive corticosteroid therapy. It is unclear whether corticosteroid therapy would be beneficial in treating people with pulmonary tuberculosis. This review evaluates whether adjunctive corticosteroid therapy reduces mortality, accelerates clinical recovery or accelerates microbiological recovery in people with pulmonary tuberculosis. The 18 included studies were conducted between 1955 and 2005 with the majority undertaken over 20 years ago before TB regimens as used today were implemented. The trials included 3816 participants in total, with only three trials having over 100 participants. Although improvement of symptoms, signs, clinical and microbiological outcomes amongst those taking corticosteroid are continually reported within publication text and narrative reviews and our findings support such comment, they should be interpreted with caution as the evidence behind these findings is of poor quality. Findings are often based upon few trials with low participant numbers.

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