Reviving an old idea: can artificial pneumothorax play a role in the modern management of tuberculosis?

To determine the usefulness of artificial pneumothorax (AP) in the management of pulmonary tuberculosis (PTB) patients when anti-tuberculosis treatment is ineffective. We evaluated the outcome of therapy in 214 patients with cavitary PTB bacteriologically confirmed by culture treated during 1998-200...

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Bibliographic Details
Published in:The international journal of tuberculosis and lung disease Vol. 10; no. 5; p. 571
Main Authors: Motus, I Y, Skorniakov, S N, Sokolov, V A, Egorov, E A, Kildyusheva, E I, Savel'ev, A V, Zaletaeva, G E
Format: Journal Article
Language:English
Published: France 01.05.2006
Subjects:
Adult
Chi-Square Distribution
Female
Humans
Pneumothorax, Artificial
Prospective Studies
Russia
Treatment Outcome
Tuberculosis, Multidrug-Resistant
Tuberculosis, Pulmonary - drug therapy
Tuberculosis, Pulmonary - therapy
Russia
ISSN:1027-3719
Online Access:Get more information
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Summary:To determine the usefulness of artificial pneumothorax (AP) in the management of pulmonary tuberculosis (PTB) patients when anti-tuberculosis treatment is ineffective. We evaluated the outcome of therapy in 214 patients with cavitary PTB bacteriologically confirmed by culture treated during 1998-2004, 78.9% of whom had multidrug resistance. AP was applied in 109 patients (56 newly diagnosed TB and 53 retreatment cases). A control group consisted of 105 patients (respectively 55 and 50) treated without AP. The average period of AP application was 4.5 months for newly diagnosed patients and 9 months in retreatment cases. Anti-tuberculosis treatment regimens in both groups were based on drug susceptibility test results. Culture negativity was achieved in patients treated with AP in all new cases and in 81.1% of retreatment cases. Cavity closure occurred in 94.6% and 67.9% respectively. In the control group, culture negativity was achieved in respectively 70.9% and 40.0%, and cavity closure occurred in respectively 56.3% and 24.0%. AP considerably improved the treatment outcome in both newly diagnosed and retreatment patients. This procedure can be considered a useful addition in managing certain patients with cavitary TB, particularly those with drug resistance.
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ISSN:1027-3719