A controlled clinical trial of short-course chemotherapy for tuberculoma of the brain.
Rajeswari Ramachandran; Sivasubramanian, S.; Balambal, R.; Parthasarathy, R.; Ranjani Ramachandran; Santha, T.; Somasundaram, P.R.; Sudha Ganapathy; Sudharsana, K.; Zaheer Ahmed Sayeed; Kalyanaraman, S.; Prabhakar, R.
Tubercle and Lung Disease; 1995; 76; 311-317.
Objective : The efficacy of short-course regimen in the treatment of brain tuberculoma and computerised tomography (CT) scan appearance before, during and after antituberculosis treatment was studied in a controlled clinical trial.
Design : Patients aged over 5 years with tuberculoma of the brain diagnosed by CT scan were randomly allocated to one of the following 2 regimens:
Regimen 1: rifampicin, isoniazid and pyrazinamide daily for an initial 3 months followed by rifampicin and isoniazid twice weekly for 6 months.
Regimen 2: rifampicin, isoniazid and pyrazinamide thrice weekly for an initial 3 months followed by rifampicin and isoniazid twice-weekly for 6 months.
The patients were followed intensively for 2 years from the start of treatment.
Results : Of the 108 patients analysed (regimen 1: 56, regimen 2: 52), at end of treatment clinical status was normal in 91% in regimen 1 and 88% in regimen 2. Of the 91 patients with scan assessments, CT scan lesions disappeared at 24 months in 77% of 47 patients in regimen 1 and 80% of 44 patients in regimen 2, and in both groups 88% of the patients were clinically normal. None had relapses requiring treatment.
Conclusions : Short-course regimens of 9 months' duration are effective in the treatment of tuberculoma of the brain; clinical recovery was faster than scan clearance.
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