Utility of broad-spectrum antibiotics for diagnosing pulmonary tuberculosis in adults: a systematic review and meta-analysis

Titus H Divala; Katherine L Fielding; Chikondi Kandulu; Marriott Nliwasa; Derek James Sloan; Ankur Gupta-Wright; Elizabeth L Corbett

doi:10.1016/S1473-3099(20)30143-2

Utility of broad-spectrum antibiotics for diagnosing pulmonary tuberculosis in adults: a systematic review and meta-analysis

Titus H Divala, Katherine L Fielding, Chikondi Kandulu, Marriott Nliwasa, Derek James Sloan, Ankur Gupta-Wright, Elizabeth L Corbett

Research output: Contribution to journal › Article › peer-review

Abstract

Suboptimal diagnostics for pulmonary tuberculosis drive the use of the so-called trial of antibiotics, a course of broad-spectrum antibiotics without activity against Mycobacterium tuberculosis that is given to patients who are mycobacteriology negative but symptomatic, with the aim of distinguishing pulmonary tuberculosis from bacterial lower respiratory tract infection. The underlying assumption—that patients with lower respiratory tract infection will improve, whereas those with pulmonary tuberculosis will not—has an unclear evidence base for such a widely used intervention (at least 26·5 million courses are prescribed per year). We aimed to collate available evidence on the diagnostic performance of the trial of antibiotics.

Original language	English
Pages (from-to)	1089-1098
Number of pages	10
Journal	Lancet Infectious Diseases
Volume	20
Issue number	9
Early online date	18 May 2020
DOIs	https://doi.org/10.1016/S1473-3099(20)30143-2
Publication status	Published - 1 Sept 2020

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10.1016/S1473-3099(20)30143-2Licence: CC BY

Divala-2020-Utility-of-broad-spectrum-LancetID-CC
Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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Derek James Sloan
- djs26st-andrews.acuk
- School of Medicine - Senior Lecturer/Consultant in Infectious Diseases
- Infection and Global Health Division
Person: Academic

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title = "Utility of broad-spectrum antibiotics for diagnosing pulmonary tuberculosis in adults: a systematic review and meta-analysis",

abstract = "Suboptimal diagnostics for pulmonary tuberculosis drive the use of the so-called trial of antibiotics, a course of broad-spectrum antibiotics without activity against Mycobacterium tuberculosis that is given to patients who are mycobacteriology negative but symptomatic, with the aim of distinguishing pulmonary tuberculosis from bacterial lower respiratory tract infection. The underlying assumption—that patients with lower respiratory tract infection will improve, whereas those with pulmonary tuberculosis will not—has an unclear evidence base for such a widely used intervention (at least 26·5 million courses are prescribed per year). We aimed to collate available evidence on the diagnostic performance of the trial of antibiotics.",

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T2 - a systematic review and meta-analysis

AU - Divala, Titus H

AU - Fielding, Katherine L

AU - Kandulu, Chikondi

AU - Nliwasa, Marriott

AU - Sloan, Derek James

AU - Gupta-Wright, Ankur

AU - Corbett, Elizabeth L

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AB - Suboptimal diagnostics for pulmonary tuberculosis drive the use of the so-called trial of antibiotics, a course of broad-spectrum antibiotics without activity against Mycobacterium tuberculosis that is given to patients who are mycobacteriology negative but symptomatic, with the aim of distinguishing pulmonary tuberculosis from bacterial lower respiratory tract infection. The underlying assumption—that patients with lower respiratory tract infection will improve, whereas those with pulmonary tuberculosis will not—has an unclear evidence base for such a widely used intervention (at least 26·5 million courses are prescribed per year). We aimed to collate available evidence on the diagnostic performance of the trial of antibiotics.

U2 - 10.1016/S1473-3099(20)30143-2

DO - 10.1016/S1473-3099(20)30143-2

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JO - Lancet Infectious Diseases

JF - Lancet Infectious Diseases

IS - 9

ER -

Utility of broad-spectrum antibiotics for diagnosing pulmonary tuberculosis in adults: a systematic review and meta-analysis

Abstract

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Derek James Sloan

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