Conservative wait-and-see therapy versus antibiotic treatment for nontuberculous mycobacterial cervicofacial lymphadenitis in children.

Abstract

BACKGROUND:

In this explorative study, 50 children with microbiologically confirmed nontuberculous mycobacterial cervicofacial lymphadenitis were randomized to either receive antibiotic therapy or follow a conservative wait-and-see approach. Our primary objective was to assess the time for all infected lymph nodes to heal in patients after the nonantibiotic, wait-and-see treatment, compared with patients after a 12-week course of clarithromycin and rifabutin.

METHODS:

Fifty children (19 boys and 31 girls) with a polymerase chain reaction (PCR)- or culture-confirmed diagnosis of cervicofacial nontuberculous mycobacterial infection were included in our study. Twenty-five children were randomized to receive antibiotic therapy and 25 to be given a wait-and-see approach.

RESULTS:

The median age of the children was 35 months (range, 14-114 months). The median time to resolution of the disease for the antibiotic group was 36 weeks, compared with 40 weeks for the wait-and-see group. Adverse effects of antibiotic therapy included gastrointestinal complaints, fever, and reversible extrinsic tooth discoloration.

CONCLUSION:

In children with an advanced stage of nontuberculous mycobacterial cervicofacial lymphadenitis, we observed no significant differences in median healing time between the wait-and-see group and the group receiving clarithromycin and rifabutin antibiotic therapy.

• Authors: Jerome A Lindeboom
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 52 Issue 2 Pg. 180-4 (Jan 15 2011) ISSN: 1537-6591 [Electronic] United States
• PMID: 21288841 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Bacterial Agents
• Rifabutin
• Clarithromycin

Topics

• Anti-Bacterial Agents (administration & dosage)
• Bacterial Infections (drug therapy)
• Child
• Child, Preschool
• Clarithromycin (administration & dosage)
• Face (pathology)
• Female
• Humans
• Infant
• Lymphadenitis (drug therapy)
• Male
• Neck (pathology)
• Rifabutin (administration & dosage)
• Time Factors
• Treatment Outcome