title: Conservative wait-and-see therapy versus antibiotic treatment for nontuberculous mycobacterial cervicofacial lymphadenitis in children.
abstract: BACKGROUND
  In this explorative study, 50 children with microbiologically confirmed nontuberculous mycobacterial cervicofacial lymphadenitis were randomized to either receive antibiotic therapy or follow a conservative wait-and-see approach. Our primary objective was to assess the time for all infected lymph nodes to heal in patients after the nonantibiotic, wait-and-see treatment, compared with patients after a 12-week course of clarithromycin and rifabutin.
  
  
  METHODS
  Fifty children (19 boys and 31 girls) with a polymerase chain reaction (PCR)- or culture-confirmed diagnosis of cervicofacial nontuberculous mycobacterial infection were included in our study. Twenty-five children were randomized to receive antibiotic therapy and 25 to be given a wait-and-see approach.
  
  
  RESULTS
  The median age of the children was 35 months (range, 14-114 months). The median time to resolution of the disease for the antibiotic group was 36 weeks, compared with 40 weeks for the wait-and-see group. Adverse effects of antibiotic therapy included gastrointestinal complaints, fever, and reversible extrinsic tooth discoloration.
  
  
  CONCLUSIONS
  In children with an advanced stage of nontuberculous mycobacterial cervicofacial lymphadenitis, we observed no significant differences in median healing time between the wait-and-see group and the group receiving clarithromycin and rifabutin antibiotic therapy.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands. a.lindeboom@amc.uva.nl
authors.forename: Jerome A
authors.initials: JA
authors.lastname: Lindeboom
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D017291:Clarithromycin / Q000008:administration & dosage; D005145:Face / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D008199:Lymphadenitis / Q000188:drug therapy*; D008297:Male; D009333:Neck / Q000473:pathology*; D017828:Rifabutin / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D017828:Rifabutin; D017291:Clarithromycin