Shortening Treatment in Adults with Non-cavitary Tuberculosis and Two-month Culture Conversion
It is widely accepted for TB treatment that persons who continue to carry TB bacteria in their sputum cannot receive shortened therapy. Therefore, it was important to understand whether clearance of TB bacteria from sputum 2 months after the start of therapy, combined with the absence of lung cavities (abscesses caused by TB) on chest X-rays was sufficient to identify patients who could be cured in a shorter amount of time.
Scientists at the Tuberculosis Research Unit (TBRU) at Case Western Reserve University and University Hospitals Case Medical Center found that a combination of two simple clinical measurements was not sufficient to select TB patients who can be cured with shortened therapy. In many patients who did not have lung cavities, cleared their sputum of bacteria, and hence were selected to receive 4 month rather than the full 6 month of therapy, TB disease came back and required additional therapy.
The findings from this trial come at a time when the research community is testing the first new antibiotics that have been developed for TB in clinical trials. One of the greatest needs in drug development is being able to indicate after only 1 month of treatment whether a new therapy has the potential to lead to faster cure.
The TBRU is a clinical research contract funded by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH).
Johnson JL et al. Shortening Treatment in Adults with Non-cavitary Tuberculosis and Two-month Culture Conversion. Am J Respir Crit Care Med. 2009 Jun 19.