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World Health Organization (WHO) antibiotic regimen against other regimens for the treatment of leprosy: a systematic review and meta-analysis

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dc.contributor.author Lazo Porras, María de los Ángeles
dc.contributor.author Prutsky, Gabriela J.
dc.contributor.author Barrionuevo, Patricia
dc.contributor.author Tapia, Jose Carlos
dc.contributor.author Ugarte Gil, Cesar Augusto
dc.contributor.author Ponce, Oscar J.
dc.contributor.author Acuña-Villaorduña, Ana
dc.contributor.author Domecq, Juan Pablo
dc.contributor.author De la Cruz-Luque, Celso
dc.contributor.author Prokop, Larry J.
dc.contributor.author Málaga Rodríguez, Germán Javier
dc.date.accessioned 2020-07-14T00:02:31Z
dc.date.available 2020-07-14T00:02:31Z
dc.date.issued 2020
dc.identifier.uri https://hdl.handle.net/20.500.12866/8323
dc.description.abstract BACKGROUND: To evaluate the effectiveness and safety of the World Health Organization antibiotic regimen for the treatment of paucibacillary (PB) and multibacillary (MB) leprosy compared to other available regimens. METHODS: We performed a search from 1982 to July 2018 without language restriction. We included randomized controlled trials, quasi-randomized trials, and comparative observational studies (cohorts and case-control studies) that enrolled patients of any age with PB or MB leprosy that were treated with any of the leprosy antibiotic regimens established by the WHO in 1982 and used any other antimicrobial regimen as a controller. Primary efficacy outcomes included: complete clinical cure, clinical improvement of the lesions, relapse rate, treatment failure. Data were pooled using a random effects model to estimate the treatment effects reported as relative risk (RR) with 95% confidence intervals (CI). RESULTS: We found 25 eligible studies, 11 evaluated patients with paucibacillary leprosy, while 13 evaluated patients with MB leprosy and 1 evaluated patients of both groups. Diverse regimen treatments and outcomes were studied. Complete cure at 6 months of multidrug therapy (MDT) in comparison to rifampin-ofloxacin-minocycline (ROM) found RR of 1.06 (95% CI 0.88-1.27) in five studies. Whereas six studies compare the same outcome at different follow up periods between 6 months and 5 years, according to the analysis ROM was not better than MDT (RR of 1.01 (95% CI 0.78-1.31)) in PB leprosy. CONCLUSION: Not better treatment than the implemented by the WHO was found. Diverse outcome and treatment regimens were studied, more statements to standardized the measurements of outcomes are needed. en_US
dc.language.iso eng
dc.publisher BioMed Central
dc.relation.ispartofseries BMC Infectious Diseases
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Clinical Protocols en_US
dc.subject World Health Organization en_US
dc.subject Drug Therapy, Combination/adverse effects en_US
dc.subject Leprostatic Agents/adverse effects/therapeutic use en_US
dc.subject Leprosy, Multibacillary/drug therapy en_US
dc.subject Leprosy, Paucibacillary/drug therapy en_US
dc.subject Minocycline/adverse effects/therapeutic use en_US
dc.subject Mycobacterium leprae/drug effects/isolation & purification en_US
dc.subject Neglected Diseases/drug therapy en_US
dc.subject Ofloxacin/adverse effects/therapeutic use en_US
dc.subject Recurrence en_US
dc.subject Rifampin/adverse effects/therapeutic use en_US
dc.subject Treatment Failure en_US
dc.title World Health Organization (WHO) antibiotic regimen against other regimens for the treatment of leprosy: a systematic review and meta-analysis en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1186/s12879-019-4665-0
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn 1471-2334


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