In-hospital mortality of intermittent vs daily antitubercular regimen in patients with meningeal tuberculosis-a retrospective study.
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Date
2012-01
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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.
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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.