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Corticosteroids in tuberculosis

J R Cisneros¹, K M Murray

¹Department of Pharmaceutical Services, Morton Plant Mease Healthcare, Clearwater, FL 34617, USA.

The Annals of Pharmacotherapy

|November 1, 1996

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Corticosteroids may worsen latent tuberculosis (TB) by promoting reactivation. However, they can benefit certain extrapulmonary TB cases by reducing symptoms and fever, though more research is needed.

Area of Science:

Medical Science
Pharmacology

Background:

Tuberculosis (TB) resurgence impacts immunocompromised populations.
Concomitant diseases may necessitate corticosteroid use in TB patients.
Corticosteroids can influence TB infection risk and presentation.

Purpose of the Study:

To evaluate corticosteroid effects in patients with latent or active tuberculosis (TB).
To discuss the role of corticosteroids in treating extrapulmonary TB.

Main Methods:

Conducted a MEDLINE search (1953-1995) and reviewed International Pharmaceutical Abstracts.
Emphasized human studies and individual case reports.
Cross-referenced relevant articles for comprehensive data.

Main Results:

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Corticosteroids may predispose patients to primary or reactivated TB infection.
Prophylaxis with isoniazid is recommended for at-risk patients.
Observed benefits in extrapulmonary TB, including tuberculous pleurisy, meningitis, and pericarditis, with improved survival and symptom reduction.
Corticosteroids can manage fever and hypersensitivity reactions.

Conclusions:

Corticosteroids can promote latent TB reactivation.
Potential benefits in modifying extrapulmonary TB symptoms exist.
Further randomized, placebo-controlled studies are required to establish definitive therapeutic roles.