Short course chemotherapy for tuberculous lymphadenitis in children

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M S Jawahar1, S Sivasubramanian, V K Vijayan

  • 1Tuberculosis Research Centre, Madras, India.

BMJ (Clinical Research Ed.)
|August 18, 1990
PubMed

Insights

A six-month chemotherapy regimen effectively treats childhood tuberculous lymphadenitis. This short-course treatment showed good compliance and favorable clinical responses, with a low retreatment rate after 36 months.

Area of Science:

  • Pediatric Infectious Diseases
  • Mycobacterial Infections
  • Clinical Pharmacology

Background:

  • Tuberculosis of the lymph nodes (scrofula) is a significant global health issue in children.
  • Traditional treatment protocols often involve lengthy durations and surgical interventions.
  • Optimizing chemotherapy regimens is crucial for improving treatment outcomes and patient adherence.

Purpose of the Study:

  • To evaluate the efficacy and tolerability of a short-course, intermittent chemotherapy regimen for pediatric tuberculous lymphadenitis.
  • To assess treatment response, compliance, and adverse reactions in children receiving the regimen.
  • To determine the long-term effectiveness and need for retreatment after the short-course therapy.

Main Methods:

  • An open, collaborative, outpatient clinical trial was conducted.
  • 168 children aged 1-12 years with confirmed tuberculous lymphadenitis were enrolled.
  • Treatment involved a 6-month intermittent chemotherapy regimen including streptomycin, rifampicin, isoniazid, and pyrazinamide, with surgery limited to diagnostic biopsy.

Main Results:

  • The regimen was well-tolerated with good compliance (60% completed within 15 days of the 6-month period).
  • Favorable clinical responses were observed in most patients, with rapid healing of sinuses and abscesses.
  • After 36 months of follow-up, only 3% of patients required retreatment for tuberculosis.

Conclusions:

  • A six-month short-course chemotherapy regimen is effective for treating tuberculous lymphadenitis in children.
  • The regimen demonstrates good tolerability and a low rate of relapse or need for re-treatment.
  • This approach offers a successful and manageable treatment strategy for pediatric scrofula.
Abstract

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