New research by scientists from the United Kingdom and Africa suggests a long-standing practice of using antibiotics to test whether an individual may have tuberculosis (TB) is an unreliable method for diagnosing the disease. In a systematic review and meta-analysis of a handful of studies that investigated the use of trial antibiotics as a diagnostic test in adults with TB symptoms, the researchers found that trial antibiotics performed poorly in ruling TB in or out in suspected cases, with sensitivity and specificity estimates that were well below internationally recommended standards for TB diagnostics. The authors of the paper say the results call for reconsideration of the practice, which has been recommended by the World Health Organization (WHO) and national TB programs for more than 30 years. “Despite more than 30 years of international guidelines and national algorithms promoting the trial of antibiotics for tuberculosis diagnosis, the small amount of data presented here on its diagnostic utility do not support the underlying rationale,” the authors wrote yesterday in The Lancet Infectious Diseases. They also suggest the use of antibiotics during TB investigations should be minimized to reduce the potential for promoting antibiotic resistance.

 

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