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There is insufficient evidence to compare equivalence of effect between fully intermittent and daily treatment in adult patients with pulmonary tuberculosis.

Rifampicin‐containing drug combinations can achieve high cure rates in patients with pulmonary tuberculosis when given for six months. Such treatment can be given either daily or intermittently (eg three times a week) from the beginning. This review compared the equivalence of effect between such treatments but did not find enough evidence to be able to assess this.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Adjunctive steroid therapy for managing pulmonary tuberculosis

Pulmonary tuberculosis is a common infectious disease. Although curable with standard anti‐pulmonary tuberculosis drugs, it has been reported that an individuals recovery could be improved by adding corticosteroids to their treatment. Current clinical guidelines advise the use of corticosteroids for treatment of other types of tuberculosis; tuberculosis meningitis and tuberculosis pericarditis. Whether corticosteroids would be beneficial in the treatment of pulmonary tuberculosis remains unclear. After reviewing the evidence available to date we found that there was not enough high quality data to support or reject corticosteroid use alongside anti‐pulmonary tuberculosis drugs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Rifabutin for treating pulmonary tuberculosis

Among current challenges in tuberculosis treatment are reducing the length of time that drugs must be taken to less than six months and finding ways to safely combine tuberculosis drugs with those used in the treatment of HIV infection. Rifabutin is a drug that has the potential to address these issues if substituted for rifampicin, a mainstay of current treatment. This review identified five trials involving 924 people, but none were of high quality. The review found no significant differences between rifabutin‐ and rifampicin‐containing treatment in curing tuberculosis and preventing relapse, but higher doses of rifabutin might be associated with more adverse effects and there was no evidence that it could shorten treatment. However, very few people with HIV and tuberculosis, who are most likely to benefit from use of rifabutin due to its lack of interaction with antiretroviral drugs, were included in the trials. Better quality clinical trials are needed to understand the place of rifabutin in the treatment of people with tuberculosis, particularly those who also have HIV.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults

Background: Accurate, rapid detection of tuberculosis (TB) and TB drug resistance is critical for improving patient care and decreasing TB transmission. Xpert® MTB/RIF assay is an automated test that can detect both TB and rifampicin resistance, generally within two hours after starting the test, with minimal hands‐on technical time. The World Health Organization (WHO) issued initial recommendations on Xpert® MTB/RIF in early 2011. A Cochrane Review on the diagnostic accuracy of Xpert® MTB/RIF for pulmonary TB and rifampicin resistance was published January 2013. We performed this updated Cochrane Review as part of a WHO process to develop updated guidelines on the use of the test.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Screening programmes for tuberculosis

Tuberculosis is a serious infectious disease that affects over nine million people each year. The disease is spread by airborne droplets, which arise in the infected lungs of tuberculosis patients. Despite widespread availability of treatment with effective antibiotic therapies, the disease remains common in many resource limited settings. This review aimed to determine whether systematic screening all the direct contacts with people with proven TB disease increases the early detection of tuberculosis. The review found that there are not currently any suitable randomized controlled trials to answer this question and there is insufficient evidence to show whether screening programmes for tuberculosis will improve the rate of diagnosis among contacts of tuberculosis patients or reduce the rate of tuberculosis in the community.Therefore there is a need for further research to determine the benefits of systematic screening of the contacts of tuberculosis patients.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Not enough evidence to support using low level laser therapy alongside drug treatments for tuberculosis

Tuberculosis (TB) is a serious bacterial infection that can affect different parts of the body; most frequently it affects the lungs (pulmonary TB). Some bacteria can be drug resistant, and some people may have the infection alongside another medical condition. People suffer from severe cough, weakness and sweats, and some people still die from TB even though effective drug treatment has been around for many years. It is has been proposed that low level laser therapy may help the drugs to be more effective. There are a number of different devices for giving the laser treatment, some giving the treatment externally (to the body or acupuncture sites), some using for internal treatment (for blood or lungs) at varying doses. The review of trials found only one randomized trial where the data were poorly reported, and it did not clarify the potential benefits and harms. Low level laser therapy should only be used in randomized controlled trials until its value is evaluated.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Isoniazid is effective in helping to prevent tuberculosis in people not infected with HIV

Tuberculosis (TB) is a serious bacterial infection and it is estimated that about a third of the world's population is infected with TB. There are a number of types, such as pulmonary TB (bacteria residing in a person's lungs) and spinal TB (in the spine). Some bacteria can be drug resistant and some people may have the infection alongside another medical condition. People suffer from severe cough, weakness and sweats, and some people still die from TB even though effective drug treatment has been around for many years. The incidence of TB has reduced in areas where the drugs are readily available. Preventing people from contracting TB in high‐risk areas is a goal worth pursuing. The review of trials using isoniazid for a six‐ to 12‐month period in people without HIV infection (HIV infected people were studied in another review) identified 11 trials involving over 90,000 people. Isoniazid was effective in preventing TB in 60% of people, although some did develop hepatitis. The findings showed that one person can be saved from getting TB when 35 people take isoniazid for six months, and one in every 200 treated will get hepatitis. The balance of benefits and harms need to be carefully considered for each setting where intervention is being considered.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

The effectiveness of oxygen for adult patients with pneumonia

Pneumonia is an inflammatory condition of the lungs. Treatment for pneumonia includes antibiotics, rest, fluids, management of complications and professional home care. Oxygen supplementation is one way to help patients who cannot breathe adequately on their own. Management of oxygen supplementation is divided into nasal cannula and mechanical ventilation. Mechanical ventilation is life‐supporting ventilation that involves the use of a machine called a ventilator, or respirator. There are two main types of mechanical ventilation: non‐invasive ventilation (NIV) and invasive ventilation. The former provides ventilatory support to a patient through a tightly fitted facial or nasal mask and the latter through a tube inserted into the windpipe through the mouth or the nose or a hole made in the windpipe through the front of the throat. At present, oxygen therapy for individuals with pneumonia is commonly prescribed. However, inconsistent results on the effects of oxygen therapy on pneumonia have been reported and no systematic review has been conducted in patients with pneumonia to determine which delivery system of oxygen therapy leads to the best clinical outcomes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Antibiotic treatment for nontuberculous mycobacteria in people with cystic fibrosis 

Nontuberculous mycobacteria are bacteria that are in the same family as tuberculosis and are commonly found in the soil and water. These bacteria can be found in the lungs of people with cystic fibrosis and can cause their lung function to worsen. Although there are guidelines on which antibiotics to use to treat lung infection due to these bacteria, these recommendations are not specific for people with cystic fibrosis. It is also not clear which are the most effective antibiotics. The main purpose of this review was to determine whether treatment with different antibiotic combinations for nontuberculous mycobacterial infection would improve lung function or decrease the frequency of chest infections in people with cystic fibrosis. We did not find any randomized controlled trials which we could include in the review. Randomized controlled trials are needed to inform clinicians which are the best drugs for treating these infections in people with cystic fibrosis. In the meantime, clinicians should follow the current guidelines for the diagnosis and treatment of lung infections due to nontuberculous mycobacteria in the general population.   

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Substituting or adding fluoroquinolones to established first‐line antituberculous drug regimens gives no additional benefit or risks

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis bacteria. Over two billion people worldwide are believed to be latently infected with TB and approximately 10% of these people will develop active TB later in life. The World Health Organization currently only recommend treatment with fluoroquinolones for patients who cannot take standard first‐line drugs. In this review, we examined the effect of including fluoroquinolones in first‐line treatment regimens on people with presumed drug‐sensitive tuberculosis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

The effect of lay health workers on mother and child health and infectious diseases

A lay health worker is a member of the community who has received some training to promote health or to carry out some healthcare services, but is not a healthcare professional. In the studies in this review, lay health workers carried out different tasks. These included giving help and advice about issues such as child health, child illnesses, and medicine taking. In some studies, lay health workers also treated people for particular health problems.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Mucolytic drugs (to help make phlegm easier to cough up) for people with bronchiectasis

Review question: This review considered the question of whether mucolytics may be helpful for people with bronchiectasis who do not also have cystic fibrosis. Studies of participants with cystic fibrosis were not included in this review, and we are unable to draw any conclusions on this treatment's relevance to people with cystic fibrosis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Cardiopulmonary Syndromes (PDQ®): Patient Version

Expert-reviewed information summary about common conditions that produce chest symptoms. The cardiopulmonary syndromes addressed in this summary are cancer-related dyspnea, malignant pleural effusion, pericardial effusion, and superior vena cava syndrome.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: February 13, 2015

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