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Treatment of extrapulmonary tuberculosis.
Seminars in Respiratory Infections
|September 1, 1989
Summary
Short-course chemotherapy using isoniazid and rifampin for 9 months is highly effective for extrapulmonary tuberculosis (EP), achieving over 95% success. This treatment offers a successful therapeutic option for drug-sensitive EP cases.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Pulmonary tuberculosis (TB) therapy duration is now 6-9 months.
- Limited data exists on short-course chemotherapy (SCC) for extrapulmonary tuberculosis (EP).
- EP presents unique challenges due to diverse disease sites.
Purpose of the Study:
- To evaluate the efficacy of 9-month SCC for extrapulmonary tuberculosis.
- To assess the effectiveness of isoniazid (INH) and rifampin (RIF) in treating EP.
Main Methods:
- A 9-month SCC regimen was administered to 478 EP patients.
- Regimen: INH 300 mg and RIF 600 mg daily for 1 month, followed by INH 900 mg and RIF 600 mg twice weekly for 8 months.
- Alternative daily dosing of INH and RIF was also assessed.
Main Results:
- Overall success rate exceeded 95% in patients who completed therapy.
- Median follow-up was 42 months.
- Daily drug administration showed similar high success rates.
Conclusions:
- Nine-month SCC with INH and RIF is highly effective for drug-sensitive extrapulmonary tuberculosis.
- The regimen demonstrates significant success in treating EP.
- SCC offers a viable and effective treatment strategy for EP.