Accompanying Immunomodulatory Therapy in Treatment of Patients with Neglected Tuberculosis

The aim of this research was to study the effectiveness of cycloferon inclusion in the complex of treatment and rehabilitation measures for patients with fibrous-cavernous pulmonary tuberculosis. In this regard, an analysis of 158 patients with fibrous-cavernous pulmonary tuberculosis was performed. The patients were divided into 2 groups: the main group (54 patients), in addition to etiotropic therapy, received a complex of therapeutic and rehabilitation measures, including preparation of cycloferon administered according to a modified procedure at a dose of 0.25 g 2 times per week until the end of the intensive phase of the main treatment. The comparison group consisted of 104 patients who received etiotropic therapy and a complex of therapeutic and rehabilitation measures: vitamin therapy, physiotherapy, and psychological support. The effectiveness of etiotropic therapy was evaluated after the end of the intensive phase of the main course of treatment which lasted no more than 3 months, and 5 months in the presence of drug-resistant forms and other aggravating factors. It was revealed that the effectiveness of treatment in patients with fibrous-cavernous pulmonary tuberculosis is determined not only by the etiology of the disease course, the duration of the main course of treatment, and the presence of a pathogen resistant to anti-tuberculosis drugs, but also by a number of factors that influence patient adherence to treatment in a complex way. Unfavorable outcomes of treatment of this form of the disease were observed in patients with chronic course of the disease (F6=0.89), caused by a multidrug-resistant agent (F8=0.65), and among those released from prison (F2=0.34). However, even short-term use of accompanying therapy with cycloferon allows increasing the effectiveness of treatment, improving the course of the process, including stopping the release of mycobacteria in 94.1% of patients with concomitant diseases. It is possible that the described effect of cycloferon as an accompanying therapy is based not only on its direct effect on patient's immunodeficiency, but also its indirect effect on the increase in adherence to treatment due to cessation of violations of the treatment regimen and other purely psychological factors that require further study.

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