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[Therapeutic pneumothorax--an effective adjuvant method in treating multidrug-resistant tuberculosis]
1Institutul de Pneumologie Marius Nasta, Bucureşti.
Pneumologia (Bucharest, Romania)
|October 4, 2000
Summary
Therapeutic pneumothorax (TP) can aid drug treatment for multidrug-resistant tuberculosis (MDR TB) in select cases with unilateral lesions. This approach, combined with drug therapy, achieved favorable outcomes and bacteriological negativity in three patients.
Area of Science:
- Pulmonology
- Infectious Diseases
- Medical History
Background:
- Treatment of multidrug-resistant tuberculosis (MDR TB) presents significant challenges due to drug toxicity, high costs, and limited efficacy.
- Therapeutic pneumothorax (TP), a historical treatment, demonstrated effectiveness before the antibiotic era.
- The potential utility of TP as an adjunct therapy for MDR TB warrants investigation.
Observation:
- Three cases of MDR TB with unilateral lesions and resistance to 2, 3, or 4 drugs were treated.
- Therapeutic pneumothorax (TP) was employed as an adjunctive measure to standard drug treatment, guided by antibiogram results.
- One case involving resistance to four drugs was further managed with a lobectomy after three months of TP and drug therapy.
Findings:
- All three patients receiving TP alongside drug treatment achieved sustained bacteriological negativity.
- Favorable clinical outcomes were observed in all cases.
- The patients were considered healed after an 18-month follow-up period.
Implications:
- Therapeutic pneumothorax (TP) can be a valuable supplementary treatment for specific cases of multidrug-resistant tuberculosis (MDR TB), particularly when pleural adhesions are absent.
- This study highlights the potential of revisiting historical treatments like TP in the context of modern challenges in infectious disease management.
- Pulmonologists should consider TP as a viable option for selected MDR TB patients to improve treatment outcomes.