[Treatment duration of extra-pulmonary tuberculosis: 6 months or more? TB-INFO database analysis].

Abstract

PURPOSE:

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.

CONCLUSION:

A period of 6 months seems to be sufficient to treat extrapulmonary tuberculosis (except for neuromeningeal localization).

• Authors: S Bouchikh, J Stirnemann, V Prendki, R Porcher, H Kesthmand, A-S Morin, P Cruaud, S Rouaghe, D Farge, O Fain
• Journal: La Revue de medecine interne (Rev Med Interne) Vol. 33 Issue 12 Pg. 665-71 (Dec 2012) ISSN: 1768-3122 [Electronic] France
• Vernacular Title: Durée de traitement des tuberculoses extrapulmonaires : six mois ou plus ? Analyse de la base de données TB-INFO.
• PMID: 22703726 (Publication Type: Evaluation Study, Journal Article, Multicenter Study)
• Copyright: Copyright © 2012. Published by Elsevier SAS.

Chemical References

• Antitubercular Agents

Topics

• AIDS-Related Opportunistic Infections (drug therapy)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Algorithms
• Antitubercular Agents (therapeutic use)
• Cohort Studies
• Continuity of Patient Care (statistics & numerical data)
• Data Interpretation, Statistical
• Databases, Factual (statistics & numerical data)
• Drug Administration Schedule
• Female
• HIV Infections (complications, drug therapy, epidemiology)
• Humans
• Male
• Middle Aged
• Paris (epidemiology)
• Patient Compliance (statistics & numerical data)
• Retrospective Studies
• Time Factors
• Tuberculosis (complications, drug therapy, epidemiology)
• Young Adult