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Intermittent versus daily therapy for treating tuberculosis in children
Anuradha Bose1, Soumik Kalita, Winsley Rose
1Department of Community Health, Christian Medical College, Vellore, India, 632002.
The Cochrane Database of Systematic Reviews
|January 29, 2014
Summary
Current evidence is insufficient to determine if intermittent or daily treatment is better for childhood tuberculosis (TB). More research is needed to inform optimal TB treatment regimens for children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Childhood tuberculosis (TB) is a significant global health issue.
- While daily, six-month rifampicin-containing regimens are effective, poor adherence hinders treatment success.
- Intermittent regimens show potential for better adherence, but their efficacy compared to daily treatment remains unclear.
Purpose of the Study:
- To compare the efficacy and safety of intermittent (twice- or thrice-weekly) versus daily short-course anti-TB regimens in treating childhood TB.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) and quasi-RCTs involving children (≤15 years) diagnosed with TB.
- Searched multiple databases and trial registries up to May 2013 without language restrictions.
- Included trials using rifampicin-containing regimens for at least two months, comparing intermittent to daily treatment.
Main Results:
- Four trials (563 children) compared twice-weekly intermittent to daily regimens; no significant difference in cure rates was detected (very low quality evidence).
- Trials were too small and used non-standard regimens, limiting conclusions on cure, death, relapse, and adverse events.
- Adherence rates were similar between intermittent and daily regimens (87% vs. 84%).
- No trials compared the commonly used thrice-weekly regimen with daily treatment.
Conclusions:
- Existing trials are insufficient to support or refute intermittent short-course TB treatment over daily regimens in children.
- Further high-quality randomized trials in high TB-transmission settings are necessary to guide policy and practice.
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