TY - JOUR T1 - A prospective observational study to determine the adequacy of 6 months antitubercular therapy in tubercular mediastinal lymphadenopathy JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p2698 AU - Akanksha Jha AU - Nirmal Jain AU - Rohan Aurangabadwalla AU - Nitin Jain AU - Mehul Thakkar AU - Nalin Joshi Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p2698.abstract N2 - Background: The present study was designed to evaluate adequacy of 6months antituberculosis therapy (ATT), Revised National Tuberculosis Control Programme (RNTCP) Cat I with isoniazid (H), rifampicin (R), pyrazinamide (Z), ethambutol (E) followed by HR thrice weekly in patients with tubercular mediastinal lymphadenopathy (TML).Material & methods: 75 cases of significant mediastinal lymphadenopathy on contrast enhanced CT chest (CECT Chest) and diagnosis of Tuberculosis on transbronchial needle aspiration were included. All patients were given 6months ATT [2(HRZE)3/4(HR)3]as per RNTCP and followed up at the end of 2,5 and 6 months for clinico-radiological assessment. CECT Chest done at the end of 6months and treatment was extended with (HR)3 in patients with persistent significant lymphadenopathy (>1 cm) on CT Chest. Repeat CECT Chest was done 3 monthly till complete radiological response.Results: Mean age of patients was 27.5±14.38 years with M:F ratio of 3:2. Common symptoms were fever (88%), dry cough (70%) and anorexia (60%). Right paratracheal (73%), Pretracheal (67%) were commonest lymph node groups involved. Only 15 out of 75 patients (20%) showed evidence of complete clinico-radiological improvement at end of 6 months while 5 (6.67%) patients were lost to follow up. Remaining 55 patients needed extended treatment (HR)3. 46 (61.33%) patients had complete clinico-radiological improvement at end of 9 months, while 9 (12%) patients required 12 months ATT.Conclusion: 74% of the patients with TML required ATT for more than 6months (9-12 months) compared to 20% of the patients in whom 6 months ATT was adequate.The results suggest that 6months RNTCP CAT I is inadequate for treating TML. ER -