[Treatment duration of extra-pulmonary tuberculosis: 6 months or more? TB-INFO database analysis].
OBJECTIVE
The recommended duration of pulmonary tuberculosis therapy is 6 months. For extrapulmonary tuberculosis, treatment duration depends on tuberculosis involvement and HIV status. The objective of this study was to describe the main characteristics of a cohort of extrapulmonary tuberculosis patients, to compare patients with a 6-month treatment to those with more than a 6-month treatment, and to analyze the compliance of medical centres with recommended duration of treatment.


METHODS
A retrospective cohort study of 210 patients with extrapulmonary tuberculosis was carried from January 1999 to December 2006 in two hospitals in the north-east of Paris. These patients were treated with quadruple therapy during two months, followed by dual therapy during 4 months (n=77) or more (n=66). The characteristics of each group were compared by uni- and multivariate analysis. The primary endpoint was the rate of relapse or treatment failure at 24-month follow-up after treatment completion.


RESULTS
No relapse was observed after 24 months of follow-up after the end of treatment in the two groups. In univariate analysis, patients with lymph node tuberculosis were more often treated for 6 months than at other sites of tuberculosis (respectively 61% versus 40.9%; P=0.02); the decision of treatment duration was related to medical practices (79.2% treated 6 months in one hospital versus 20.7% in the other, P<0.001); patients living in private residence were more often treated during 6 months than patients living in residence (24.2% versus 10.3%, P=0.042). In multivariate analysis, only hospital (P=0.046), sex (P=0.007) and private residence were significantly different in each group.


CONCLUSIONS
A period of 6 months seems to be sufficient to treat extrapulmonary tuberculosis (except for neuromeningeal localization).
Service de médecine interne, université Paris-13, hôpital Jean-Verdier, AP-HP, avenue du 14-Juillet, 93140 Bondy, France.
S
S
Bouchikh
J
J
Stirnemann
V
V
Prendki
R
R
Porcher
H
H
Kesthmand
A-S
AS
Morin
P
P
Cruaud
S
S
Rouaghe
D
D
Farge
O
O
Fain
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D003627:Data Interpretation, Statistical; D016208:Databases, Factual / Q000706:statistics & numerical data; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010297:Paris / Q000453:epidemiology; D010349:Patient Compliance / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult
D000995:Antitubercular Agents