Prospective randomized study of thrice weekly six-month and nine-month chemotherapy for cervical tuberculous lymphadenopathy.
The aim of this study is to compare the efficacy of a thrice weekly 6-month regimen, 4S3H3R3Z3/2H3R3 (which consists of an initial 4 months of streptomycin (S), isoniazid (H), rifampicin (R), and pyrazinamide (Z) followed by 2 months of isoniazid and rifampicin), with a thrice weekly 9-month regimen, 4S3H3R3Z3/5H3R3 (which consists of an initial 4 months of streptomycin, isoniazid, rifampicin, and pyrazinamide followed by 5 months of isoniazid and rifampicin), in the treatment of cervical tuberculous lymphadenopathy. A total of 113 patients were recruited between August 1987 and December 1993. Twenty-two patients were excluded from the analysis because of defaulting treatment or modification of regimen. Ninety-one patients were included in the analysis. Forty-three patients were given the 6-month regimen, and 48 patients were given the 9-month regimen. Two (5%) patients of the 6-month regimen and one (2%) patient of the 9-month regimen had primary failure after completion of treatment (relative risk, 2.23; 95% confidence interval, 0.21 to 23.76). Of the 88 patients who had initial clinical remission after completion of treatment, the 5-year actuarial remission rates were 89% for the 6-month regimen and 90% for the 9-month regimen (Wilcoxon, p = 0.44). There were no significant differences of both primary failure rate and 5-year actuarial remission rate of the two regimens. The 6-month regimen is recommended as the initial treatment of tuberculous lymphadenopathy.
Yuen
A P
AP
Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Wong
S H
SH
Tam
C M
CM
Chan
S L
SL
Wei
W I
WI
Lau
S K
SK
D000284:Administration, Oral; D000328:Adult; D000904:Antibiotics, Antitubercular / Q000008:administration & dosage / Q000627:therapeutic use*; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D007538:Isoniazid / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009333:Neck; D011446:Prospective Studies; D012189:Retrospective Studies; D012293:Rifampin / Q000008:administration & dosage / Q000627:therapeutic use*; D013307:Streptomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014388:Tuberculosis, Lymph Node / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology*
D000904:Antibiotics, Antitubercular; D007538:Isoniazid; D012293:Rifampin; D013307:Streptomycin