Short Course Chemotherapy in Childhood Tuberculosis

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Abstract
Four hundred and thirty-seven children registered as having tuberculosis between November 1984 and June 1986 entered a prospective trial of short course chemotherapy. Two hundred and eighty-six children had pulmonary and 151 had extrapulmonary tuberculosis. Most children received 2 months daily treatment in hospital with rifampicin, isoniazid, pyrazlnamide, and streptomycin (‘A’ regimen), followed by 4 months twice a week outpatient treatment with rifampicin and isoniazid (‘B’ regimen). A minority, who lived too far from an outpatient clinic, received 3 months of ‘A’ regimen before being discharged on 3 months daily isoniazid at home. Response to treatment was rapid and dramatic. Adverse drug reactions occurred in eight patients. Two hundred and sixty-nine children completed ‘A’ and ‘B’ regimens, and a further 32 completed 3 months of ‘A’ regimen. Ten died and 25 transferred. One hundred and one defaulted during ‘A’ or ‘B’ regimen. On follow-up, after completion of treatment, there have been two relapses and three deaths. Short course chemotherapy for tuberculosis in children is most effective. It achieves a rapid clinical improvement, has minimal side effects, and considerably increases patient compliance.

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