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[Efficiency of shorter chemotherapy courses for intrathoracic tuberculosis in children]
Insights
Shorter chemotherapy regimens for pediatric intrathoracic tuberculosis, including isoniazid, rifampicin, pyrazinamide, and streptomycin, significantly reduced treatment duration and improved healing outcomes with fewer side effects.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Clinical Pharmacology
Background:
- Intrathoracic tuberculosis in children requires effective and tolerable chemotherapy.
- Optimizing treatment duration is crucial for pediatric patient outcomes.
Purpose of the Study:
- To evaluate differential chemotherapy regimens for pediatric intrathoracic tuberculosis.
- To assess the efficacy and safety of shorter treatment courses.
Main Methods:
- A study involving 255 children aged 3-12 years with active tuberculosis.
- Comparison of a shorter, intensive three-drug regimen (isoniazid, rifampicin, pyrazinamide, streptomycin) with a control group (without pyrazinamide).
Main Results:
- Shorter therapy reduced treatment duration to 6.4 months (uncomplicated) and 9.2 months (complicated).
- Improved healing observed in 85.3% (uncomplicated) and 60.0% (complicated) of children.
- Shorter treatment had fewer side effects (20% vs. 36%) and no increase in recurrence (2.7%).
Conclusions:
- Shorter chemotherapy regimens are effective and well-tolerated for pediatric intrathoracic tuberculosis.
- This approach leads to better healing and reduced adverse events compared to longer treatments.
Abstract:
To develop differential chemotherapy regimes for intrathoracic tuberculosis in children aged 3-12 years, 255 children with active tuberculosis underwent clinical and X-ray examination. Of them, 120 children received shorter chemotherapy in an early intensive phase by using three drugs (isoniazid, rifampicin, and pyrazinamide supplemented by streptomycin) in complicated tuberculosis. A control group (n = 135) had therapy without pyrazinamide. Shorter courses of therapy were shown not only to reduce total treatment duration on an average to 6.4 and 9.2 months in uncomplicated and complicated tuberculosis, respectively, but to contribute to more perfect healing processes and resolution of abnormal changes in 85.3 and 60.0% of children with uncomplicated and complicated forms, respectively. At the same time shorter treatment is well tolerated. It shows much fewer side effects than does longer treatment (20 and 36%). There are no increases in the incidence of recurrent tuberculosis late at follow-up (2.7 and 2.7%, respectively).