Unfinished battle with childhood tuberculosis: Is it curable with less drugs and shorter duration?
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Tarih
2013
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Etkili tedavi rejimleriyle mortalitesi tüm dünyada azalmış olsa da tüberküloz halen global bir sağlık problemidir. Tedaviye uyumsuzluk, ilaç direnci, tedavi başarısızlığı ve relaps tüberküloz tedavisi sırasında sık karşılaşılan problemlerdir. İntermittan tedavi rejimlerinin, özellikle kaynakları sınırlı bölgelerde, tedavi maliyetini ve tedavinin yan etkilerini azalttığı, hastanın tedaviye uyumunu artırdığı bilinmektedir; ayrıca çocuk hastalarda da her gün verilen tedavi kadar etkili olduğu gösterilmiştir. Bu çalışmada, hastanemizde pulmoner ve ekstrapulmoner tüberküloz tanısı almış çocuk hastalara iki ilaçla verilen 6 ve 9 aylık intermittan tüberküloz tedavi rejimlerinin sonuçları karşılaştırılmıştır. Materyal ve Metod: Hastanemizde 1986 ile 2001 yılları arasında akciğer, lenf nodu, iskelet sistemi, plevral, abdominal, miliyer, perikardiyal, deri ve böbrek tüberkülozu nedeniyle intermittan antitüberküloz tedavi alan 115 hasta retrospektif olarak değerlendirilmiştir. Elli bir hastaya 15 gün süreyle izoniazid ve rifampisin tedavisi sonrası 9 ay süreyle aynı ilaçlarla ve aynı dozlarda haftada iki gün intermittan tedavi verilmiştir. Altmış dört hastaya ise aynı tedavi rejimi 6 ay süreyle uygulanmıştır. Bulgular: Tedavinin ilk ayında 1. gruptaki (9 aylık intermittan tedavi) pulmoner tüberkülozlu hastaların %75'inde, 2. gruptaki (6 aylık intermittan tedavi) pulmoner tüberkülozlu hastaların %79'unda klinik düzelme gözlendi. Pulmoner tüberkülozlu hastalarda ilk 6 ayda, grup 1'de %81'inde, grup 2'de %86'sında radyolojik düzelme görüldü. Klinik ve radyolojik düzelme zamanları karşılaştırıldığında iki grup arasında anlamlı bir farklılık saptanmadı (p 0.05). Benzer sonuçlar ekstrapulmoner tüberkülozlu hastalarda da gözlendi (p 0.05). Hastalar 7 ay ile 15 yıl arasında takip edildi. Hiçbir olguda erken relaps gözlenmedi. Dokuz aylık intermittan tedavi alan (grup 1) 4 hastada, tedavi kesildikten iki yıl sonra geç relaps görüldü. Sonuç:Çocukluk çağı pulmoner ve menenjit dışı ekstrapulmoner tüberkülozda, iki ilaçla 6 aylık intermittan tedavi, 9 aylık intermittan tedavi kadar etkilidir.
Introduction: Tuberculosis is still a global health problem all over the world despite its mortality has been decreased with effective treatment regimens. Poor treatment adherence, acquired drug resistance, treatment failure and relapse are the major problems during the course of the tuberculosis treatment. Intermittent regimens have the advantages of reducing the side effects and the cost of the therapy and increasing the adherence, especially in resource-limited areas; and have been documented to be as effective as daily regimen in the paediatric population. In this study, we compared the results of 6-month and 9-month intermittent-therapy regimens with two drugs, given to the children with pulmonary and extrapulmonary tuberculosis at our hospital. Materials and Methods: One hundred and fifteen patients with pulmonary and extrapulmonary tuberculosis other than meningitis, who had been given intermittent anti-tuberculosis therapy between 1986 and 2001, were evaluated retrospectively. Fifty one patients were given isoniazid and rifampin daily for 15 days, followed by the same drugs and doses twice weekly for a total of 9-months. Also, 64 patients were treated with the same regimen for a total of 6-months. Results: Clinical recovery was observed in 75% and 79% of pulmonary tuberculosis patients at the first month of therapy in group 1 (9-month group) and group 2 (6-month group), respectively. Radiological recovery was noted between 0-6 months in 81% of the patients in group 1 and 86% of the patients in group 2. According to the clinical and radiological recovery times, no significant difference was detected between the two groups (p< 0.05). Similar results had been observed in extrapulmonary tuberculosis (p< 0.05). Follow-up periods ranged from 7 months to 15 years. There was no case of early relapse. Late relapse was noted in 4 patients, who had been received 9-month therapy (group 1). Conclusion: Six-month intermittent therapy with two drugs is as efficacious as 9-month intermittent-therapy in childhood pulmonary and extrapulmonary tuberculosis, other than meningitis.
Introduction: Tuberculosis is still a global health problem all over the world despite its mortality has been decreased with effective treatment regimens. Poor treatment adherence, acquired drug resistance, treatment failure and relapse are the major problems during the course of the tuberculosis treatment. Intermittent regimens have the advantages of reducing the side effects and the cost of the therapy and increasing the adherence, especially in resource-limited areas; and have been documented to be as effective as daily regimen in the paediatric population. In this study, we compared the results of 6-month and 9-month intermittent-therapy regimens with two drugs, given to the children with pulmonary and extrapulmonary tuberculosis at our hospital. Materials and Methods: One hundred and fifteen patients with pulmonary and extrapulmonary tuberculosis other than meningitis, who had been given intermittent anti-tuberculosis therapy between 1986 and 2001, were evaluated retrospectively. Fifty one patients were given isoniazid and rifampin daily for 15 days, followed by the same drugs and doses twice weekly for a total of 9-months. Also, 64 patients were treated with the same regimen for a total of 6-months. Results: Clinical recovery was observed in 75% and 79% of pulmonary tuberculosis patients at the first month of therapy in group 1 (9-month group) and group 2 (6-month group), respectively. Radiological recovery was noted between 0-6 months in 81% of the patients in group 1 and 86% of the patients in group 2. According to the clinical and radiological recovery times, no significant difference was detected between the two groups (p< 0.05). Similar results had been observed in extrapulmonary tuberculosis (p< 0.05). Follow-up periods ranged from 7 months to 15 years. There was no case of early relapse. Late relapse was noted in 4 patients, who had been received 9-month therapy (group 1). Conclusion: Six-month intermittent therapy with two drugs is as efficacious as 9-month intermittent-therapy in childhood pulmonary and extrapulmonary tuberculosis, other than meningitis.
Açıklama
Anahtar Kelimeler
Çocukluk çağı tüberkülozu, İntermittant antitüberküloz tedavi, Childhood tuberculosis, Intermittent anti-tuberculosis treatment
Kaynak
Tüberküloz ve Toraks
WoS Q Değeri
Scopus Q Değeri
Q3
Cilt
61
Sayı
4
Künye
Pekcan, S., Cinel, G., Kiper, N., Koyun, M., Köse, M., Çobanoğlu, N., Tana Aslan, A., Yalçın, E., Doğru, D., Özçelik, U., Göçmen, A. (2013). Unfinished battle with childhood tuberculosis: Is it curable with less drugs and shorter duration? Tüberküloz ve Toraks, 61, 4, 320-326.
