Short course chemotherapy for tuberculosis of lymph nodes: a controlled trial. British Thoracic Society Research...

One hundred and fifty two patients with tuberculosis of lymph nodes were enrolled in a randomised trial of nine versus 18 months' chemotherapy. The regimens consisted of rifampicin plus isoniazid for nine or 18 months, supplemented initially by ethambutol for eight weeks. At 36 months data from 113 patients were available for analysis, of whom 56 had received the short course regimen. Progress during chemotherapy was uneventful in 84 of the 113 patients. Fresh nodes appeared in 13 patients and existing nodes increased in size in 13; these events occurred within the first eight months of treatment. In 10 patients residual nodes were palpable at the end of chemotherapy. Events including enlargement of nodes, appearance of new nodes, fluctuation, and formation of sinuses occurred in 12 patients after the end of chemotherapy. The incidence of these events was similar in both groups, and they did not result in an unfavourable outcome. Nine months' treatment with rifampicin and isoniazid supplemented initially by ethambutol should be adequate for tuberculosis of lymph nodes, but confirmation must await a longer period of follow up.