Short course chemotherapy for pulmonary tuberculosis in children.
Padma Ramachandran; Kripasankar, A.S.; Duraipandian, M.
Indian Journal of Tuberculosis; 1998; 45; 83-87.
A total of 137 children with pulmonary tuberculosis were treated with one of the following 2 regimens: the first regimen consisted of two drugs namely isoniazid and rifampicin administered daily for nine months (9HR) and the second of isoniazid, rifampicin and pyrazinamide thrice a week for the first two months followed by isoniazid and rifampicin twice a week for the next 4 months (2 H 3 R 3 Z 3 /4H 2 R 2 ). The diagnosis was based on radiological abnormality which was classified as most probable (category A) and probable (category B). On admission, 56% of the patients were aged less than 5 years, tuberculin test with 1 TU was positive in 72% and a history of contact with a known case of tuberculosis present in 78%. Of the 137 patients, 50% were treated with regimen I and the remaining 50% were treated with regimen II while 41 % of the patients were classified as category A and 59% as category B. Culture was positive for M. tuberculosis in a total of 44 (32%) patients.
The results were similar in both the regimens indicating that 6 months' intermittent therapy with 3 drugs in the initial 2 months' is as effective as the 9 months' daily therapy with 2 drugs. Both the nodal and parenchymal lesions resolved to the same extent at the end of treatment. The residual lesions continued to improve even after stopping treatment. Mortality and drop out rates were very low and adverse reactions negligible.
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