ABSTRACT
Intravesical bacillus Calmette-Guérin (BCG) is widely used for the treatment of transitional cell carcinoma of the bladder. Although it is usually well tolerated, sepsis can occur, which has resulted in at least eight deaths [3]. The survival of Connaught BCG-infected mice treated with single and combination antibiotic and steroid therapy was evaluated. Triple-drug therapy with isoniazid, rifampin, and prednisolone resulted in 53% survival compared with 25% survival in the control group (P = 0.0209). A survival of only 10.5% was observed with treatment using prednisolone alone. This survival was worse than that of the control group (25%), and approached statistical significance (P = 0.0669). Our data suggest that BCG sepsis probably has components of both a hypersensitivity reaction and bacterial sepsis; they support the current use of combination antibiotic and steroid therapy for treatment of BCG sepsis in humans, but argue against treatment with steroids alone.
Subject(s)
Mycobacterium bovis , Tuberculosis/drug therapy , Animals , Body Weight , Cycloserine/therapeutic use , Drug Combinations , Isoniazid/therapeutic use , Mice , Mice, Inbred C3H , Prednisone/therapeutic use , Rifampin/therapeutic use , Survival Analysis , Tuberculosis/mortality , Tuberculosis/pathologyABSTRACT
Recurrent transitional cell carcinoma of the bladder can pose many challenging treatment options. We present an unusual case requiring multiple forms of treatment and a discussion of these treatments.
