BACKGROUND To evaluate the effectiveness and safety of the World Health Organization antibiotic regimen for the treatment of paucibacillary (PB) and multibacillary (MB) leprosy compared to other available regimens. METHODS We performed a search from 1982 to July 2018 without language restriction. We included randomized controlled trials, quasi-randomized trials, and comparative observational studies (cohorts and case-control studies) that enrolled patients of any age with PB or MB leprosy that were treated with any of the leprosy antibiotic regimens established by the WHO in 1982 and used any other antimicrobial regimen as a controller. Primary efficacy outcomes included: complete clinical cure, clinical improvement of the lesions, relapse rate, treatment failure. Data were pooled using a random effects model to estimate the treatment effects reported as relative risk (RR) with 95% confidence intervals (CI). RESULTS We found 25 eligible studies, 11 evaluated patients with paucibacillary leprosy, while 13 evaluated patients with MB leprosy and 1 evaluated patients of both groups. Diverse regimen treatments and outcomes were studied. Complete cure at 6 months of multidrug therapy (MDT) in comparison to rifampin-ofloxacin-minocycline (ROM) found RR of 1.06 (95% CI 0.88-1.27) in five studies. Whereas six studies compare the same outcome at different follow up periods between 6 months and 5 years, according to the analysis ROM was not better than MDT (RR of 1.01 (95% CI 0.78-1.31)) in PB leprosy. CONCLUSION Not better treatment than the implemented by the WHO was found. Diverse outcome and treatment regimens were studied, more statements to standardized the measurements of outcomes are needed.

中文翻译：

---

世界卫生组织（WHO）针对其他麻风病治疗方法的抗生素治疗方案：系统评价和荟萃分析。

背景技术与其他可用的治疗方案相比，为了评估世界卫生组织抗生素治疗麻风杆菌（PB）和多细菌（MB）麻风病的有效性和安全性。方法我们从1982年至2018年7月进行了无语言限制的搜索。我们纳入了随机对照试验，半随机试验和比较观察性研究（队列研究和病例对照研究），这些研究纳入了任何年龄段的PB或MB麻风病患者，并接受了WHO在1982年制定的任何麻风抗生素治疗方案并使用其他任何抗菌药物作为控制剂。主要疗效结果包括：完全的临床治愈，病变的临床改善，复发率，治疗失败。使用随机效应模型汇总数据，以95％的置信区间（CI）评估报告为相对风险（RR）的治疗效果。结果我们找到了25项合格研究，其中11例评估了脓疱性麻风病患者，13例评估了MB麻风病患者，1例对两组患者进行了评估。研究了不同的治疗方案和结果。在五项研究中，与利福平-氧氟沙星-米诺环素（ROM）相比，在6个月的多药疗法（MDT）完全治愈时，RR为1.06（95％CI 0.88-1.27）。尽管有六项研究在6个月至5年的不同随访期间比较了相同的结果，但根据分析，ROM并不优于PB麻风病的MDT（RR为1.01（95％CI 0.78-1.31））。结论没有发现比WHO更好的治疗方法。