{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:28:35Z","timestamp":1791347315591,"version":"4.3.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2009,9,1]],"date-time":"2009-09-01T00:00:00Z","timestamp":1251763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100008136","name":"Case Western Reserve University","doi-asserted-by":"publisher","award":["NO1-AI95383"],"award-info":[{"award-number":["NO1-AI95383"]}],"id":[{"id":"10.13039\/100008136","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008136","name":"Case Western Reserve University","doi-asserted-by":"publisher","award":["HHSN266200700022C\/NO1-AI-70022"],"award-info":[{"award-number":["HHSN266200700022C\/NO1-AI-70022"]}],"id":[{"id":"10.13039\/100008136","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,9,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Cavitary disease and delayed culture conversion have been associated with relapse. Combining patient characteristics and measures of bacteriologic response might allow treatment shortening with current drugs in some patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess whether treatment could be shortened from 6 to 4 months in patients with noncavitary tuberculosis whose sputum cultures converted to negative after 2 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was a randomized, open-label equivalence trial. HIV-uninfected adults with noncavitary tuberculosis were treated daily with isoniazid, rifampin, pyrazinamide, and ethambutol for 2 months, followed by 2 months of isoniazid and rifampin. After 4 months, patients with drug-susceptible TB whose sputum cultures on solid media were negative after 8 weeks of treatment were randomly assigned to continue treatment for 2 more months or to stop treatment. Patients were followed for relapse for 30 months after beginning treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Enrollment was stopped by the safety monitoring committee after 394 patients were enrolled due to apparent increased risk for relapse in the 4-month arm. A total of 370 patients were eligible for per protocol analysis. Thirteen patients in the 4-month arm relapsed, compared with three subjects in the 6-month arm (7.0 vs. 1.6%; risk difference, 0.054; 95% confidence interval with Hauck-Anderson correction, 0.01\u20130.10).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Shortening treatment from 6 to 4 months in adults with noncavitary disease and culture conversion after 2 months using current drugs resulted in a greater relapse rate. The combination of noncavitary disease and 2-month culture conversion was insufficient to identify patients with decreased risk for relapse.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.200904-0536oc","type":"journal-article","created":{"date-parts":[[2009,6,19]],"date-time":"2009-06-19T22:02:47Z","timestamp":1245448967000},"page":"558-563","source":"Crossref","is-referenced-by-count":121,"title":["Shortening Treatment in Adults with Noncavitary Tuberculosis and 2-Month Culture Conversion"],"prefix":"10.1093","volume":"180","author":[{"given":"John L.","family":"Johnson","sequence":"first","affiliation":[{"name":"Tuberculosis Research Unit, Department of Medicine, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Jamil","family":"Hadad","sequence":"additional","affiliation":[{"name":"N\u00facleo de Doen\u00e7as Infecciosas, Centro de Ci\u00eancias da Sa\u00fade, Universidade Federal do Esp\u00edrito Santo, Vit\u00f3 ria, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reynaldo","family":"Dietze","sequence":"additional","affiliation":[{"name":"N\u00facleo de Doen\u00e7as Infecciosas, Centro de Ci\u00eancias da Sa\u00fade, Universidade Federal do Esp\u00edrito Santo, Vit\u00f3 ria, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethel Leonor","family":"Noia Maciel","sequence":"additional","affiliation":[{"name":"N\u00facleo de Doen\u00e7as Infecciosas, Centro de Ci\u00eancias da Sa\u00fade, Universidade Federal do Esp\u00edrito Santo, Vit\u00f3 ria, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barrett","family":"Sewali","sequence":"additional","affiliation":[{"name":"Uganda-Case Western Reserve University Research Collaboration, Makerere University College of Health Sciences, Mulago Hospital, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phineas","family":"Gitta","sequence":"additional","affiliation":[{"name":"Uganda-Case Western Reserve University Research Collaboration, Makerere University College of Health Sciences, Mulago Hospital, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alphonse","family":"Okwera","sequence":"additional","affiliation":[{"name":"Uganda-Case Western Reserve University Research Collaboration, Makerere University College of Health Sciences, Mulago Hospital, Kampala, Uganda"},{"name":"Ugandan National Tuberculosis and Leprosy Programme, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy D.","family":"Mugerwa","sequence":"additional","affiliation":[{"name":"Uganda-Case Western Reserve University Research Collaboration, Makerere University College of Health Sciences, Mulago Hospital, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Rose","family":"Alcaneses","sequence":"additional","affiliation":[{"name":"Tropical Diseases Foundation, Makati City, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Imelda","family":"Quelapio","sequence":"additional","affiliation":[{"name":"Tropical Diseases Foundation, Makati City, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thelma E.","family":"Tupasi","sequence":"additional","affiliation":[{"name":"Tropical Diseases Foundation, Makati City, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Libby","family":"Horter","sequence":"additional","affiliation":[{"name":"Tuberculosis Research Unit, Department of Medicine, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara M.","family":"Debanne","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen D.","family":"Eisenach","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences, Little Rock, Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. 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