Authors: Motus, I.Y.; Skorniakov, S.N.; Sokolov, V.A.; Egorov, E.A.; Kildyusheva, E.I.; Savel'ev, A.V.; Zaletaeva, G.E.

Source: The International Journal of Tuberculosis and Lung Disease, Volume 10, Number 5, May 2006 , pp. 571-577(7)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

OBJECTIVE: To determine the usefulness of artificial pneumothorax (AP) in the management of pulmonary tuberculosis (PTB) patients when anti-tuberculosis treatment is ineffective.

DESIGN: We evaluated the outcome of therapy in 214 patients with cavitary PTB bacteriologically confirmed by culture treated during 1998–2004, 78.9% of whom had multidrug resistance. AP was applied in 109 patients (56 newly diagnosed TB and 53 retreatment cases). A control group consisted of 105 patients (respectively 55 and 50) treated without AP. The average period of AP application was 4.5 months for newly diagnosed patients and 9 months in retreatment cases. Anti-tuberculosis treatment regimens in both groups were based on drug susceptibility test results.

RESULTS: Culture negativity was achieved in patients treated with AP in all new cases and in 81.1% of retreatment cases. Cavity closure occurred in 94.6% and 67.9% respectively. In the control group, culture negativity was achieved in respectively 70.9% and 40.0%, and cavity closure occurred in respectively 56.3% and 24.0%.

CONCLUSION: AP considerably improved the treatment outcome in both newly diagnosed and retreatment patients. This procedure can be considered a useful addition in managing certain patients with cavitary TB, particularly those with drug resistance.

Keywords: tuberculosis; MDR-TB; artificial pneumothorax

Document Type: Regular paper

Affiliations: 1: Urals Research Institute of Phthisiopulmonology, Ekaterinburg, Russia

Publication date: 2006-05-01

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• The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

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