In-hospital mortality of intermittent vs daily antitubercular regimen in patients with meningeal tuberculosis-a retrospective study.

Abstract
Introduction: The Revised National Tuberculosis Control Programme (RNTCP), the State-run Tuberculosis Control Initiative of the Government of India, recommends intermittent thrice a week Directly Observed Treatment Short course (DOTS) both during intensive phase and continuation phase for a total of nine months for tubercular meningitis. However, most recent guidelines recommend daily regimen. Objective: Assessment of the in-hospital mortality in patients with meningeal tuberculosis. Material and Methods: We retrospectively analyzed the data of patients (n-98) admitted with a diagnosis of meningeal tuberculosis from January Ist 2006 to December 3lst 2009 in a tertiary care centre in South India. Thwaites index score of four or less was used for diagnosis of meningeal tuberculosis which is a weighted diagnostic index score for dichotomised clinical variables including age, blood white cell count, duration of illness, CSF total white cell count, and CSF neutrophil percentage. We compared in-hospital treatment outcome of patients on thrice weekly intermittent DOTS regimen with daily regimen patients. Results: The inhospital mortality was same (27%) in the two treatment regimens (p 0.944). However, there was less incidence of hepatic dysfunction in the intermittent DOTS regimen, even though it was not statistically significant (p 0.148). Conclusions: In the short term, both regimens have similar mortality outcomes and no statistically significant difference in hepatic dysfunction during the hospital stay.
Description
Keywords
Chronic meningitis, Rifampicin, Treatment outcome, Drug induced liver injury, Steroids
Citation
Iype Thomas, George Litta Elizabeth, Cherian Ajith, Kumar Aswini, Ajitha B K, Chandy Sinchu, Kumar K Vijaya. In-hospital mortality of intermittent vs daily antitubercular regimen in patients with meningeal tuberculosis-a retrospective study. Indian Journal of Tuberculosis. 2012 Jan; 59(1): 6-11.