[Aerosolized therapy with streptomycin and steroids in treatment of bronchial stenosis due to endobronchial tuberculosis].
We had reported that aerosolized therapy with streptomycin and steroids is useful for ulcerative EBTB. However, the effectiveness of this therapy for bronchial stenosis has yet to be clarified. This study was undertaken to determine the effectiveness of aerosolized streptomycin and steroids in the treatment of bronchial stenosis due to EBTB. We performed flexible bronchoscopy in 64 patients with active erosive or ulcerative EBTB. Flexible bronchoscopy was performed at least twice in 54 patients, 27 patients treated with conventional therapy and 27 patients treated with aerosol therapy. In those, we estimated the degree of bronchial stenosis between the first and last bronchoscopic examinations. We compared conventional therapy with aerosol therapy to clarify the usefulness of aerosol therapy for bronchial stenosis. We graded bronchial stenosis as minimal, mild, moderate, severe, or obstructive. We assessed the follow-up of bronchial stenosis as aggravation, no change, or improvement, using the first and last endoscopic findings. "Improvement" was defined as the last endoscopic findings improving by at least two grades. "Aggravation" was defined as the last endoscopic findings worsening by at least two grades. Other cases were defined as "no change". Conventional therapies led to aggravation in 13 patients, no change in 13 patients, and improvement in 1 patient. Aerosol therapy led to no change in 24 patients, improvement in 3 patients. No patients developed aggravation. The differences between the therapeutic groups were significant. We concluded that aerosol therapy with streptomycin and steroids helps to treat bronchial stenosis due to ulcerative EBTB.
Rikimaru
T
T
First Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan.
Oizumi
K
K
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000336:Aerosols; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D000904:Antibiotics, Antitubercular / Q000008:administration & dosage*; D001982:Bronchial Diseases / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D001999:Bronchoscopy; D003251:Constriction, Pathologic; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013256:Steroids; D013307:Streptomycin / Q000008:administration & dosage*; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000473:pathology
D000336:Aerosols; D000893:Anti-Inflammatory Agents; D000904:Antibiotics, Antitubercular; D004338:Drug Combinations; D013256:Steroids; D013307:Streptomycin