The Role of Adrenocorticotrophic and Adrenocorticosteroid Hormones in the Treatment of Tuberculosis

McLean, Ross L.

doi:10.1111/j.1749-6632.1963.tb16631.x

Cited by 10 publications

(1 citation statement)

References 22 publications

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“…101,103 Despite these benefits, however, there were no longterm differences between groups in several outcomes: corticosteroids failed to influence the rates of ultimate treatment failure or relapse, 102 cavity closure, 101,103 adverse reactions to antituberculous medications, 101,103 or mortality rates. 101,102,104 In another randomized trial, 141 results of pulmonary function tests, measured 2 to 3 years later, did not differ between the corticosteroid recipients and controls. Among observed adverse effects, HIV-infected patients receiving corticosteroids had a greater increment in CD4 counts but also a higher HIV RNA level, although no difference occurred in rates of herpesvirus infections, Kaposi sarcoma, or moderate or worse candidiasis (mean follow-up duration, 34 months).…”

Section: Pulmonary Tuberculosismentioning

confidence: 93%

Use of Corticosteroids in Treating Infectious Diseases

McGee¹

2008

Arch Intern Med

109

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linicians have generally avoided prescribing corticosteroids for active infection because of their known immunosuppressive effects and concern about long-term complications. We conducted a review of the published randomized, double-blind trials comparing corticosteroids and placebo in infections. Except in some trials of viral infections, sore throat, and cerebral cysticercosis, all patients also received active antimicrobial agents in addition to placebo or corticosteroids. For patients with bacterial meningitis, tuberculous meningitis, tuberculous pericarditis, severe typhoid fever, tetanus, or pneumocystis pneumonia with moderate to severe hypoxemia, treatment with corticosteroids improved patient survival (group 1 infections). For patients with bacterial arthritis, corticosteroids were also beneficial and reduced long-term disability (group 2 infections). For about a dozen other infections, corticosteroids significantly relieved symptoms (group 3 infections), and clinicians should consider using them if symptoms are substantial. Corticosteroids were harmful in 2 infections, viral hepatitis and cerebral malaria (group 5 infections). We conclude that corticosteroids are beneficial and safe for a wide variety of infections, although courses longer than 3 weeks should be withheld from patients with concomitant human immunodeficiency virus infection and low CD4 counts.

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Section: Pulmonary Tuberculosismentioning

confidence: 93%

Use of Corticosteroids in Treating Infectious Diseases

McGee¹

2008

Arch Intern Med

109

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Adjunctive steroid therapy for managing pulmonary tuberculosis

Critchley

Orton

Pearson

2014

Cochrane Database of Systematic Reviews

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It is unlikely that adjunctive corticosteroid treatment provides major benefits for people with pulmonary tuberculosis. Short term clinical benefits found did not appear to be maintained in the long term. However, evidence available to date is of low quality. In order to evaluate whether adjunctive corticosteroids reduce mortality, or accelerate clinical or microbiological recovery in people with pulmonary tuberculosis further large randomized control trials sufficiently powered to detect changes in such outcomes are needed.

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