Duration of Chemothrapy for Tuberculous Cervical Lymphadenitis: A Randomized Controlled Study on Six Months versus Twelve Months Chemotherapy / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Tuberculous cervical lymphadenitis is one of the most common extrapulmonary manifestations of tuberculosis. Foreign guidelines recommend a six-month short course chemotherapy for tuberculous peripheral lymphadenitis as an initial standard regimen. However, there have been some debates about the duration of chemotherapy in South Korea. The aim of this study is to determine the reasonable duration of chemotherapy for tuberculous cervical lymphadenitis in a randomized controlled study. SUBJECTS AND METHOD: We analyzed clinical outcome of 80 patients with tuberculous cervical lymphadenitis treated at Korea University Medical Center from April 1998 to November 2001. All patients were randomized in two groups by treatment regimens. All patients were given antituberculous chemotherapy for 6 or 12 months, starting with isoniazid (H), rifampicin (R), ethambutol (E) and pyrazinamide (P) for 2 months, then continuing with isoniazid, rifampicin and ethambutol for the remaining 4 months or 10 months, respectively. RESULTS: Forty-seven patients were given a 12-month regimen (2 HERZ/10 HRE), and 43 patients (91.5%) were cured. Thirty-three patients were given a 6-month regimen (2 HERZ/4 HRE), and 20 patients (60.6%) were cured. The cure rate of the 12-month regimen appeared significantly higher than that of the 6-month. In both groups, no recurrence was found during the follow up period up to 12 months. CONCLUSION: The 12-month regimen could be recommended as a reasonable chemotherapy regimen for tuberculous cervical lymphadenitis in South Korea. Single lymph node excisional biopsy is an important diagnostic method. but, it has no additional benefits of treatment.