Evidence map›Paper›PMID 33124668›Full record

SynthesisClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021

Aminoglycosides and Capreomycin in the Treatment of Multidrug-resistant Tuberculosis: Individual Patient Data Meta-analysis of 12 030 Patients From 25 Countries, 2009-2016.

J Peter Cegielski, Pei-Chun Chan, Zhiyi Lan, Zarir F Udwadia, Piret Viiklepp, Jae-Joon Yim, Dick Menzies

Open access · bronzeAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.

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  17. Tuberculosis in pregnancy.Best practice & research. Clinical obstetrics & gynaecology · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 5 countries.

J Peter CegielskiDivision of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Pei-Chun ChanDivision of Chronic Infectious Diseases, Taiwan Centers for Disease Control, Taipei City, Taiwan.
Zhiyi LanMontreal Chest Institute and McGill International Tuberculosis Centre, Montreal, Quebec, Canada.
Zarir F UdwadiaPD Hinduja National Hospital and Medical Research Institute, Mumbai, India.
Piret ViikleppEstonian Tuberculosis Registry, National Institute for Health Development, Tallinn, Estonia.
Jae-Joon YimDivision of Pulmonary and Critical Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Dick MenziesMontreal Chest Institute and McGill International Tuberculosis Centre, Montreal, Quebec, Canada.
Centers for Disease Control and Prevention · USNational Hospital · INNational Institute for Health Development · EENational Taiwan University · TWSeoul National University · KR

Funding

CIHR 143350
6 · The paper itself

Abstract

backgroundAs new drugs are developed for multidrug-resistant tuberculosis (MDR-TB), the role of currently used drugs must be reevaluated.

methodsWe combined individual-level data on patients with pulmonary MDR-TB published during 2009-2016 from 25 countries. We compared patients receiving each of the injectable drugs and those receiving no injectable drugs. Analyses were based on patients whose isolates were susceptible to the drug they received. Using random-effects logistic regression with propensity score matching, we estimated the effect of each agent in terms of standardized treatment outcomes.

resultsMore patients received kanamycin (n = 4330) and capreomycin (n = 2401) than amikacin (n = 2275) or streptomycin (n = 1554), opposite to their apparent effectiveness. Compared with kanamycin, amikacin was associated with 6 more cures per 100 patients (95% confidence interval [CI], 4-8), while streptomycin was associated with 7 (95% CI, 5-8) more cures and 5 (95% CI, 4-7) fewer deaths per 100 patients. Compared with capreomycin, amikacin was associated with 9 (95% CI, 6-11) more cures and 5 (95% CI, 2-8) fewer deaths per 100 patients, while streptomycin was associated with 10 (95% CI, 8-13) more cures and 10 (95% CI, 7-12) fewer deaths per 100 patients treated. In contrast to amikacin and streptomycin, patients treated with kanamycin or capreomycin did not fare better than patients treated with no injectable drugs.

conclusionsWhen aminoglycosides are used to treat MDR-TB and drug susceptibility test results support their use, streptomycin and amikacin, not kanamycin or capreomycin, are the drugs of choice.

Indexed as

Mycobacterium tuberculosisTuberculosis, Multidrug-ResistantAminoglycosidesAntitubercular AgentsCapreomycinHumansMicrobial Sensitivity TestsAminoglycosidesAntitubercular AgentsCapreomycinaminoglycosidescapreomycinmeta-analysismultidrug-resistant tuberculosistreatment

Identifiers

PMID33124668
PMCPMC8653626
OpenAlexW3095788911

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.