Effect of Adding Inhalation of Sodium Bicarbonate 8.4% to the Usual Treatment on Smear-Positive Pulmonary Tuberculosis: a Prospective Controlled Study

Pulmonary tuberculosis (TB) lesion is acidic, and changing this acidic pH may affect growth of TB bacilli and response to therapy. We aimed to assess the effect of adjuvant inhalation of sodium bicarbonate (SB) 8.4% on clinical, radiological, and microbiological responses in patients with sputum-positive drug-sensitive pulmonary TB. One hundred and three patients with pulmonary TB completed the study, and they were classified into two groups: group I included 55 patients who received standard anti-TB regimen plus SB inhalation, and group II included 48 patients who received anti-TB regimen only. The responses in both groups were evaluated clinically, microbiologically, and radiologically. There was no statistically significant difference between both groups in baseline bacillary load, clinical picture, and radiology. Both groups improved clinically 1 month after start of therapy. In group I only, there was a statistically significant improvement in chest radiograph after 1 month (P<0.001). The median duration of smear conversion for group I was 3 weeks (1–8) compared with 9.5 (2–17) in group II, with a statistically significant difference (P<0.001). Moreover, the median duration of culture conversion for group I was 1 month (1–3) compared with 3 months (1–4) in group II, with a statistically significant difference (P<0.001). Adjuvant inhalation of SB in smear-positive pulmonary TB to standard anti-TB drugs accelerates smear conversion, culture conversion, and clinical and radiological improvement.