Evaluation of oral erythromycin and local isoniazid instillation therapy in infants with Bacillus Calmette-Guérin lymphadenitis and abscesses.
A randomized placebo-controlled prospective trial was conducted to evaluate the efficacy of erythromycin therapy in 69 patients affected with Bacillus Calmette-Guérin lymphadenitis. When patients who developed subsequent regional abscesses were excluded, erythromycin caused significantly earlier resolution of lymphadenitis (5.1 months vs. 5.7 months for placebo; P < 0.01) compared with placebo. There was no significant difference in the proportion of patients who developed subsequent regional abscesses between the 2 groups (47% for erythromycin, 60% for placebo, P = 0.14). When the entire group of 69 patients was evaluated for "duration to heal" (regardless of subsequent abscess formation), erythromycin therapy (4.1 +/- 1.5 SD months) did not differ significantly from the placebo group (3.5 +/- 1.3 months, P = not significant). Patients who developed subsequent abscess (n = 36) along with those with B. Calmette-Guérin regional abscesses at presentation (n = 27) were further studied to compare oral erythromycin therapy with that of single dose 50-mg intranodal isoniazid instillation. Local isoniazid therapy caused significantly earlier resolution of the abscesses (3.9 months) compared with erythromycin therapy (5.2 months; P < 0.001).
Noah
P K
PK
Department of Paediatrics, University of the West Indies, Kingston, Jamaica.
Pande
D
D
Johnson
B
B
Ashley
D
D
D000038:Abscess / Q000188:drug therapy* / Q000209:etiology; D000284:Administration, Oral; D001500:BCG Vaccine / Q000009:adverse effects*; D004917:Erythromycin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007322:Instillation, Drug; D007538:Isoniazid / Q000008:administration & dosage / Q000627:therapeutic use*; D008199:Lymphadenitis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D009163:Mycobacterium bovis / Q000302:isolation & purification; D011446:Prospective Studies
D001500:BCG Vaccine; D004917:Erythromycin; D007538:Isoniazid