In-hospital mortality of intermittent vs daily antitubercular regimen in patients with meningeal tuberculosis--a retrospective study
2012
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 1st 2006 to December 31st 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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