G de Bruyn1, P Garner. 1. Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D3-100, PO Box 19024, Seattle, WA 98275, USA. gdebruyn@fhcrc.org
Abstract
BACKGROUND: Some authorities have advocated Mycobacterium vaccae immunotherapy for treating tuberculosis and other infections caused by mycobacteria. OBJECTIVES: To assess the effects of Mycobacterium vaccae as an adjunct to chemotherapy for treating tuberculosis. SEARCH STRATEGY: We searched the Cochrane Infectious Diseases Group trials register (September 2002), the Cochrane Controlled Trials register (Issue 3, 2002), MEDLINE (1966 to October 2002), EMBASE (1980 to September 2002), and reference lists of articles. We also contacted organisations and individuals working in the field. SELECTION CRITERIA: Randomised and quasi-randomised trials using whole, killed Mycobacterium vaccae for patients with tuberculosis. DATA COLLECTION AND ANALYSIS: One reviewer assessed trial quality and extracted data. MAIN RESULTS: Seven trials met the inclusion criteria. There was no effect on mortality (4 trials, OR 1.09, 95% CI 0.79 to 1.49). No consistent effect on sputum negativity or sputum culture was shown. Most immunotherapy recipients experienced local adverse reactions (2 trials, OR 18.2, 95% CI 9 to 37), some of which progressed to ulceration and scarring. REVIEWER'S CONCLUSIONS: Mycobacterium vaccae does not benefit patients with tuberculosis.
BACKGROUND: Some authorities have advocated Mycobacterium vaccae immunotherapy for treating tuberculosis and other infections caused by mycobacteria. OBJECTIVES: To assess the effects of Mycobacterium vaccae as an adjunct to chemotherapy for treating tuberculosis. SEARCH STRATEGY: We searched the Cochrane Infectious Diseases Group trials register (September 2002), the Cochrane Controlled Trials register (Issue 3, 2002), MEDLINE (1966 to October 2002), EMBASE (1980 to September 2002), and reference lists of articles. We also contacted organisations and individuals working in the field. SELECTION CRITERIA: Randomised and quasi-randomised trials using whole, killed Mycobacterium vaccae for patients with tuberculosis. DATA COLLECTION AND ANALYSIS: One reviewer assessed trial quality and extracted data. MAIN RESULTS: Seven trials met the inclusion criteria. There was no effect on mortality (4 trials, OR 1.09, 95% CI 0.79 to 1.49). No consistent effect on sputum negativity or sputum culture was shown. Most immunotherapy recipients experienced local adverse reactions (2 trials, OR 18.2, 95% CI 9 to 37), some of which progressed to ulceration and scarring. REVIEWER'S CONCLUSIONS:Mycobacterium vaccae does not benefit patients with tuberculosis.
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