PREDNISONE AS AN ADJUNCT IN CHEMOTHERAPY OF LYMPH NODE-BRONCHIAL TUBERCULOSIS IN CHILDHOOD - A DOUBLE-BLIND STUDY .2. FURTHER TERM OBSERVATION

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Abstract
To evaluate the effectiveness of steroids as an adjunct to the chemotherapy of lymph node-bronchial tuberculosis in childhood, a double-blind study using prednisone was made of 117 children with primary tuberculosis of not more than 6 months'' duration. Fifty-eight received prednisone and 59 received a placebo in addition to isoniazid and PAS [para-amino salicylic acid] therapy. The diagnosis of lymph node-bronchial disease was made by bronchoscopy and roentgenogram of the chest. Patients in both groups showed varying degrees of response, favorable or otherwise. The over-all improvement (67.2%) in the patients treated with prednisone was greater compared with that in the placebo group (45.7 %). This difference was significant (P <0.05). Also a higher percentage of marked improvement occurred among the steroid-treated group, namely, 36% compared with 15% in the control group. Sex, age, and race were comparable in the 2 groups. The duration and stage of endo-bronchial disease were the important factors affecting therapeutic response. No harmful effects were seen in any child given prednisone nor was there any apparent risk of increased infections in patients receiving prednisone in this study. At autopsy (still under study) extensive tuberculosis was found despite the long-continued antimicrobial therapy.

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