[Corticosteroids as adjuvants in the treatment of tuberculosis]

The anti-inflammatory effect of corticosteroids has been known for a long time, as have their use in treating diseases with an inflammatory component. Corticosteroids have also been used as an adjunct in treating tuberculosis. We have reviewed the literature to evaluate the rationale for our present treatment strategy. We find no reason for the use of Isoniazide in routine prophylaxis of Mantoux positive or former tuberculosis patients who are treated with corticosteroids. Corticosteroids could be added when treating severe pulmonary tuberculosis. When treating tuberculous pericarditis and severe tuberculous pleurisy, corticosteroids should be used as an adjunct to the antituberculous chemotherapy. No controlled studies have been carried out in patients with tuberculous meningitis, but retrospective reports have shown a lower mortality in patients treated with steroids. In children with stenosis and atelectasis because of endobronchial obstruction due to tuberculosis in mediastinal lymphnodes, corticosteroids should be added to the usual antituberculous regimen.