1. Vitamin D as an Adjunctive Treatment to Standard Drugs in Pulmonary Tuberculosis Patients: An Evidence-Based Case Report
- Author
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Stella Marsudidjadja, Diana Ashilah Rifai, Diajeng Ayesha Soeharto, Aisha Emilirosy Roekman, Melva Louisa, and Chadijah Karima Assegaf
- Subjects
medicine.medical_specialty ,Tuberculosis ,Population ,Review Article ,vitamin D deficiency ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Vitamin D and neurology ,Medicine ,030212 general & internal medicine ,education ,030304 developmental biology ,0303 health sciences ,education.field_of_study ,business.industry ,lcsh:Public aspects of medicine ,lcsh:RA1-1270 ,General Medicine ,medicine.disease ,Clinical trial ,Adjunctive treatment ,Inclusion and exclusion criteria ,Sputum ,medicine.symptom ,business - Abstract
Background. Vitamin D has a prominent role in the body’s innate immunity as it is important in the maintenance of macrophages and monocytes and its function in defending against infections.In-vitrostudies have established vitamin D’s potential role in tuberculosis (TB) infection, in that it restrictsMycobacterium tuberculosisgrowth, thus implying the potential benefit of vitamin D as an adjunctive treatment for TB. However, clinical trials and reviews have contradicting findings regarding the true clinical efficacy of adjunctive vitamin D, particularly in reducing the sputum conversion rate (SCR).Objective. This study aims to update the current evidence regarding vitamin D supplementation as an adjunctive treatment in achieving the smear sputum conversion rate (SCR) among pulmonary TB patients.Method. A comprehensive search was conducted in October 2018 in PubMed-NCBI, MEDLINE-OVID, SCOPUS-Elsevier, and Cochrane. The selection of studies was done as per the predetermined inclusion and exclusion criteria of this EBCR and resulted in the inclusion of 11 eligible studies (8 RCTs and 3 systematic reviews). The selected studies were then critically appraised for their validity, importance, and applicability according to the CEBM (Centre for Evidence-Based Medicine) appraisal tools.Results. Overall, most of the trials showed no statistically significant changes in terms of the proportion of TB patients with a negative sputum smear conversion in the group treated with an adjunctive therapy vs. the group treated with standard antituberculosis therapy alone. Only one trial showed significant results, which was conducted in a population of TB patients with vitamin D deficiency. Furthermore, overall the reviews showed no significant change in the 8-week sputum smear conversion after treatment within the group given vitamin D in comparison to those who were not.Conclusion. Vitamin D as adjunctive therapy in TB patients shows no clinical improvement in terms of sputum conversion to antituberculosis management.
- Published
- 2019