Difficulties in the treatment of pulmonary tuberculosis in children
Brînză, N.; Mihăescu, T.
Revista Medico-Chirurgicala a Societatii de Medici Si Naturalisti Din Iasi 111(4): 852-855
2007
ISSN/ISBN: 0048-7848 PMID: 18389769 Document Number: 612323
The management of pulmonary tuberculosis in children in Romania is done according to ERS, WHO and IUATLD recommendations, Iaşi area being included since 1998 in the pilot study. We analyzed in a descriptive and retrospective study 254 children with pulmonary tuberculosis admitted to the Iaşi Department of Pediatric Lung Diseases in the interval January 2000 - December 2005. The surveyed parameters included: treatment course, side effects of antituberculous drugs, and an assessment of the cases at the end of treatment. This analysis revealed: 98.8% were new cases, 47.2% had received four-drug regimen for the first 2 months, 46.9% 3-drug regimen and 5.9% individualized treatment. Of the four-drug regimen 92.5% cases were treated with ethambutol. Of the 5.9% with individualized treatment 12 cases had tuberculosis and HIV/AIDS, out of which 2 with MDR tuberculosis, and 1 case with virus B hepatitis; all of them had fluoroquinolones added as well as a longer period of treatment. Side effects of antituberculous medication were encountered in 4.1%, most frequent being toxic hepatitis (2.5%). Patient evaluation at the end of treatment was done according to WHO recommendations: treatment was completed in 70.5% of cases, cured: 23.6% of the cases; relapses in 2.8%, deceased in 2.8% cases. Pulmonary tuberculosis treatment in children is difficult and must take into consideration their age and nutrition status as well as the side effects and drug combinations.