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http://dx.doi.org/10.3904/kjim.2017.249

The effect of metformin on culture conversion in tuberculosis patients with diabetes mellitus  

Lee, Ye-Jin (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital)
Han, Sung Koo (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital)
Park, Ju Hee (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center)
Lee, Jung Kyu (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center)
Kim, Deog Keom (Department of Internal Medicine, Seoul National University College of Medicine)
Chung, Hee Soon (Department of Internal Medicine, Seoul National University College of Medicine)
Heo, Eun Young (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center)
Publication Information
The Korean journal of internal medicine / v.33, no.5, 2018 , pp. 933-940 More about this Journal
Abstract
Background/Aims: Patients with diabetes mellitus (DM) and tuberculosis (TB) have increased morbidity and a high risk of treatment failure or recurrence. It is important to manage both diseases simultaneously. Among anti-diabetic drugs, metformin inhibits intracellular growth of mycobacteria. Therefore, we examined the effects of metformin on TB treatment, especially in patients with DM. Methods: This retrospective cohort study included patients with culture-positive pulmonary TB diagnosed between 2011 and 2012. The primary study outcome was sputum culture conversion after 2 months of treatment. Results: Of 499 patients diagnosed with culture-positive pulmonary TB, 105 (21%) had DM at diagnosis. Among them, 62 (59.5%) were treated with metformin. Baseline characteristics, except for the presence of chronic renal disease, were not significantly different between the metformin and non-metformin groups. Metformin treatment had no significant effect on sputum culture conversion (p = 0.60) and recurrence within 1 year after TB treatment completion (p = 0.39). However, metformin improved the sputum culture conversion rate in patients with cavitary pulmonary TB, who have higher bacterial loads (odds ratio, 10.8; 95% confidence interval, 1.22 to 95.63). Conclusions: Among cavitary pulmonary TB patients with DM, metformin can be an effective adjunctive anti-TB agent to improve sputum culture conversion after 2 months of treatment.
Keywords
Metformin; Tuberculosis; Diabetes mellitus;
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