[The risk-benefit of the treatment of tuberculosis with a high bacilloscopy sensitivity in a provincial hospital].
BACKGROUND
To know the incidence and type of hepatic toxicity (HTX) of the tuberculous chemotherapy and to value the risk-benefit of treatment in our elderly population in a high sensibility context of the bacilloscopy.


METHODS
Prospective study of 161 tuberculous patients with standards of 6 months, from January 1989 to December 1994. 75 patients with (INH, FR, PZ and ETB) and 83 patients with (INH, RF and PZ). It was accomplished clinical, analytical and microbiological control to all the patients during 24 months.


RESULTS
28% of the patients had more than 65 years and a 26% HIV infection. The tuberculosis (TBC) was disseminated in a 41%. A 74% of the patients ha positive bacilloscopy. The therapeutic fulfillment was correct in a 85% of the cases. A 48% of HTX was observed, with a 9% of serious HTX (associated with alcoholism and age greater tan 60 years). In 14% of he patients was changed in a way definitive the therapeutic standard. There was a 17% of therapeutic failure (associated with disseminated TBC and HIV infection) and a 7% of relapses. The attributive mortality of TBC was of a 4%.


CONCLUSIONS
The transient and moderate increase in transaminase activity is frequent and it does not require to modify the chemotherapy. In the greater patients of 65 years the benefit of trying outweigh the risk, if is accomplished a narrow follow-up with precocious suspension of the drugs in the event of serious toxicity.
Geijo Martínez
M P
MP
Unidad de Enfermedades Infecciosas, Hospital Virgen de La Luz, Cuenca.
Martínez Medina
C
C
Herranz
C
C
Ruiz Ribó
M D
MD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology / Q000209:etiology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D017211:Treatment Failure; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality
D000995:Antitubercular Agents