Role of corticosteroid as an adjunct to antitubercular drugs in the treatment of pleural effusion: A one year study

Abstract

Background: To compare the effect of corticosteroid as an adjuvant to antitubercular treatment (ATT) in view of improving the symptoms, resolution of pleural fluid and prevention of pleural thickening. A prospective case control study was conducted in the Department of Respiratory Medicine, King George’s Medical University, Lucknow, India. Methodology: The present study has been conducted on 76 diagnosed cases of tubercular pleural effusion, 38 in case group and 38 in the control group. ATT was given to both the groups and steroid (prednisolone) was given to the case group as an adjuvant to ATT. Clinico-radiological follow-up has been done at the end of 1st, 2nd, 4th, and 6th month. Results: The mean duration of resolution of fever, cough and breathlessness in case group was significantly less as compare to control group and their differences were statistically significant with p value nd month of treatment, after that the difference was not significant. At the end of 6th month, 35 patients developed pleural thickening, out of which 21 were of the control group while the remaining 14 were of the case group. Conclusions: Use of corticosteroids as adjuvant to ATT resolve the clinical symptoms more quickly and hasten the absorption of pleural fluid and to some extent pleural thickening in patients with tubercular pleural effusion. Keywords: Tubercular Pleural Effusion; Extrapulmonary tuberculosis (EPTB); Anti-tubercular treatment; Corticosteroid.