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Short course intermittent chemotherapy in childhood tuberculosis

Intermittierende Kurzzeit-Chemotherapie bei Tuberkulose im Kindesalter

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Summary

A total of 130 children diagnosed as having pulmonary and extrapulmonary tuberculosis who received short course intermittent chemotherapy between 1978–1992 were evaluated retrospectively. One hundred and ten children with tuberculosis were treated with isoniazid (10–15 mg/kg, maximum 400 mg), rifampin (10–15 mg/kg, maximum 600 mg), and streptomycin (30 mg/kg, maximum 1 g) daily, for 15 days. Treatment was completed with similar doses of isoniazid and rifampin twice a week for a period of 9 months. Since 1986, 20 children with tuberculosis were being treated with the same regimen but without streptomycin. The majority of patients in these cases had pulmonary tuberculosis (75%), followed by lymph nodes (9%), pleural (7%), bone and joint (5%), miliary (3%), and abdominal tuberculosis (1%). The clinicoradiologic response to treatment was observed to be excellent. Only one case of relapse was detected, which was the case of a patient with lymph node tuberculosis that occurred 18 months after the completion of treatment. No serious adverse drug reaction was observed in any of the cases mentioned. In conclusion, short-course low-dose intermittent chemotherapy is an effective and economical treatment with minimal side effects for pulmonary and extrapulmonary tuberculosis in childhood.

Zusammenfassung

Zwischen 1978 und 1986 wurden in der Abteilung für Pneumologie im Kinderkrankenhaus Hacettepe 110 Patienten mit Tuberkulose 2 Wochen lang täglich mit Isoniazid (10–15 mg/kg, Maximum 400 mg/d), Rifampicin (10–15 mg/kg, Maximum 600 mg/d) und Streptomycin (30 mg/kg, Maximum 1 g/d) behandelt. Danach wurde die Therapie mit Isoniazid und Rifampicin zweimal wöchentlich in der gleichen Dosierung für insgesamt 9 Monate weitergeführt. Ab 1986 wurden 20 Patienten diesmal ohne Streptomycin also nur mit Isoniazid und Rifampicin in der gleichen Weise behandelt. Die Mehrzahl der Patienten hatte Lungentuberkulose (75%), außerdem lagen in 9% der Fälle Lymphknoten-, 7% Pleura-, 5% Gelenk- und Knochentuberkulosen, 3% miliäre und 1% abdominale Tuberkulosen vor. Bei allen Patienten war die Behandlung erfolgreich. Bei der Langzeit-Beobachtung wurde bei einem Patienten mit Lymphknotentuberkulose ein Rückfall festgestellt. Außer einem vorübergehenden Transaminasenanstieg bei einem Patienten wurden keine Nebenwirkungen beobachtet. Die kurzfristige, niedrig dosierte Intermittierende Therapie wird als eine ökonomische Therapie, mit geringen Nebenwirkungen für verschiedene Formen pulmonaler und extrapulmonaler Tuberkulose im Kindesalter vorgeschlagen.

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Correspondence to Prof. A. Göçmen M. D..

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Göçmen, A., Özçelic, U., Kiper, N. et al. Short course intermittent chemotherapy in childhood tuberculosis. Infection 21, 324–327 (1993). https://doi.org/10.1007/BF01712456

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Keywords

  • Tuberculosis
  • Rifampicin
  • Adverse Drug Reaction
  • Isoniazid
  • Rifampin