Meningitis tuberculosa esteroides

BACKGROUND: La Meningitis Tuberculosa da lugar a incapacidad o muerte a la mitad de los que la padecen. Los estudios previos eran de pequeño tamaño para resolver la cuestión de si la terapeútica adyuvante con dexametasona reduce el riesgo de incapacidad o muerte entre los adultos afectados de Meningitis Tuberculosa. y el efecto de la coinfección con VIH no estaba clara. METODOS: rolado con placebo en Vietnan en sujetos por encima de 14 años de edad que presentaban meningitis tuberculosa, con o sin infección VIH para detrminar si la terapia adyuvante con dexametasona reducía el riesgo de incapacidad severa o muerte después de nueve meses de seguimiento We conducted prespecified subgroup analyses and intention-to-treat analyses. RESULTADOS: A total of 545 patients were randomly assigned to groups that received either dexamethasone (274 patients) or placebo (271 patients). Only 10 patients ( percent) had been lost to follow-up at nine months of treatment. Treatment with dexamethasone was associated with a reduced risk of death (relative risk, ; 95 percent confidence interval, to ; P=). It was not associated with a significant reduction in the proportion of severely disabled patients (34 of 187 patients [ percent] among survivors in the dexamethasone group vs. 22 of 159 patients [ percent] in the placebo group, P=) or in the proportion of patients who had either died or were severely disabled after nine months (odds ratio, ; 95 percent confidence interval, to ; P=). The treatment effect was consistent across subgroups that were defined by disease-severity grade (stratified relative risk of death, ; 95 percent confidence interval, to ; P=) and by HIV status (stratified relative risk of death, ; 95 percent confidence interval, to ; P=). Significantly fewer serious adverse events occurred in the dexamethasone group than in the placebo group (26 of 274 patients vs. 45 of 271 patients, P=). CONCLUSIONES: El tratamiento adyuvante con dexametasona mejora la supervivencia de los pacientes por encima de los 14 años con meningitis tuberculosa pero probablemente no previene la incapacidad severa.

Meningitis tuberculosa esteroides

meningitis tuberculosa esteroides

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