Arginine Supplementation in Patients diagnosed with drug-sensitive Pulmonary tuberculosis

Objective. To determine the effects of arginine in the rates of sputum conversion in patients with drug-sensitive pulmonary tuberculosis.

Methods. Studies from PubMed, Medline, EMBASE, and Cochrane were reviewed and appropriate studies were included. Randomized controlled trials comparing arginine with placebo in adult patients with drug-sensitive pulmonary tuberculosis were included. The risk of bias was assessed using the Cochrane Risk of Bias tool. A metaanalysis of the rate of sputum conversion at 8 weeks, was conducted. Post hoc analyses of sputum conversion at 4 weeks, and cough reduction at 4 and 8 weeks were done.

Results. Three articles included in this study had a pooled population of 452 participants. This meta-analysis showed no significant difference in the sputum conversion at 4 and 8 weeks, with a relative risk of 0.96 (95% CI 0.77-1.20) and 1.07 (95% CI 0.96-1.19), respectively. However, cough was significantly reduced at 4 and 8 weeks, with subtotal relative risks of 0.91 (95% CI 0.82-1.00) and 0.43 (95% CI 0.22-0.81), and a total relative risk for cough reduction of 0.83 (95% CI 0.73-0.93).

Conclusion. While arginine may not significantly reduce sputum conversion rates, it may be used as an adjunct to decrease cough in patients with tuberculosis.