Outcomes of Category III DOTS treatment in immunocompetent patients with tuberculosis pleural effusion
DESIGN: This prospective, multicentre, observational study recruited 351 patients between 2006 and 2010. Patients were regularly followed up clinically as well as with ultrasound examination of the chest.
RESULTS: Successful outcome (clinical response with complete resolution on ultrasound examination at 6 months) was seen in 274 patients (78.1%). Efficacy was 88.9% (excluding defaulters), and 94% among those completing follow-up as per protocol. None of the patients received corticosteroids. Other outcomes included treatment extension (n = 26, 7.4%), default (n = 43, 12.2%), treatment failure (n = 3, 0.9%) and death (n = 3, 0.9%). Seventy-nine mild/moderate adverse events and one treatment-related serious adverse event were noted; one patient developed recurrent drug-induced hepatotoxicity. Two patients (0.7%) had relapse/re-infection at 24 months follow-up.
CONCLUSION: Intermittent thrice-weekly treatment for 6 months with three drugs in the intensive phase is effective and safe for unilateral small pleural effusion in immunocompetent patients. Although Category III no longer exists in the programme, the results are reassuring for intermittent treatment in extra-pulmonary TB under programme conditions.
Document Type: Research Article
Affiliations: 1: Department of Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India 2: Department of Pulmonary Medicine, Sir Byramjee Jeejeebhoy Medical College, Ahmedabad, India 3: Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati, India 4: Department of Chest Diseases and Tuberculosis, Sawai Man Singh Medical College, Jaipur, India 5: National Centre for Disease Control, Ministry of Health and Family Welfare, Government of India, New Delhi, India
Publication date: November 1, 2012
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