Prospective randomized study of thrice weekly six-month and nine-month chemotherapy for cervical tuberculous lymphadenopathy

Otolaryngol Head Neck Surg. 1997 Feb;116(2):189-92. doi: 10.1016/S0194-59989770323-1.

Abstract

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.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Antibiotics, Antitubercular / administration & dosage
  • Antibiotics, Antitubercular / therapeutic use*
  • Biopsy, Needle
  • Female
  • Humans
  • Injections, Intramuscular
  • Isoniazid / administration & dosage
  • Isoniazid / therapeutic use*
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification
  • Neck
  • Prospective Studies
  • Retrospective Studies
  • Rifampin / administration & dosage
  • Rifampin / therapeutic use*
  • Streptomycin / administration & dosage
  • Streptomycin / therapeutic use*
  • Treatment Outcome
  • Tuberculosis, Lymph Node / drug therapy*
  • Tuberculosis, Lymph Node / microbiology
  • Tuberculosis, Lymph Node / physiopathology*

Substances

  • Antibiotics, Antitubercular
  • Isoniazid
  • Rifampin
  • Streptomycin