{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T18:08:21Z","timestamp":1789063701053,"version":"build-2803163510"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chonnam National University Hospital Biomedical Research Institute.","award":["BCRI24033"],"award-info":[{"award-number":["BCRI24033"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cavity on chest radiograph is recognized as an independent risk factor for recurrence in pulmonary tuberculosis (TB), but evidence supporting extended treatment in these patients remains limited, particularly in real-world data from Korea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective analysis using data from a multicenter prospective cohort of patients with pulmonary tuberculosis enrolled at 18 Korean institutions, comparing recurrence rates between standard treatment (\u2264200 days) and extended treatment (&gt;200 days) among drug-susceptible pulmonary TB patients with cavity on chest radiograph.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 159 patients, 58 (36.5%) received standard treatment and 101 (63.5%) received extended treatment. Baseline sputum smear positivity was higher in the extended group (29.3% vs. 56.4%, p\u2009=\u20090.002), but 2-month culture positivity (6.3% vs. 4.4%, p\u2009&gt;\u20090.999) and time to culture conversion (8.00\u2009\u00b1\u20093.91 vs. 7.45\u2009\u00b1\u20093.73 weeks, p\u2009=\u20090.454) were similar. Recurrence during post-treatment follow-up occurred in 4 patients (2.5%) and did not differ between groups (3.4% vs. 2.0%, p\u2009=\u20090.966). Treatment interruption due to adverse drug reactions was more frequent with extended treatment (1.7% vs. 7.9%, p\u2009=\u20090.204), while overall adverse event rates were comparable. In a fixed-time analysis using Firth\u2019s penalized logistic regression, extended treatment showed a numerically lower risk of recurrence, although statistical significance was not reached (adjusted odds ratio [aOR], 0.07; 95% confidence interval [CI], 0.01\u20131.06; p\u2009=\u20090.056). Among covariates, low body mass index was associated with recurrence, but this estimate was very imprecise and should be interpreted with caution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cavity on chest radiograph alone may not be sufficient to justify routine extension of treatment beyond 200 days. Because only four recurrence events were observed, the adjusted association favoring extended treatment was imprecise and should be interpreted as exploratory rather than definitive. Larger prospective studies that systematically capture microbiologic response and detailed radiologic disease burden are needed to identify which patients with cavitary disease may benefit from individualized treatment extension.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0357772","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:33:47Z","timestamp":1789061627000},"page":"e0357772","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extended treatment duration and recurrence in successfully treated drug-susceptible pulmonary tuberculosis with cavity on chest radiograph"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8336-4426","authenticated-orcid":true,"given":"Chang-Seok","family":"Yoon","sequence":"first","affiliation":[{"name":"Chonnam National University Hospital, Chonnam National University Medical School","place":["Gwangju, Republic of Korea"],"department":["Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae-Ok","family":"Kim","sequence":"additional","affiliation":[{"name":"Chonnam National University Hospital, Chonnam National University Medical School","place":["Gwangju, Republic of Korea"],"department":["Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong-Joon","family":"Shin","sequence":"additional","affiliation":[{"name":"Chonnam National University Hospital, Chonnam National University Medical School","place":["Gwangju, Republic of Korea"],"department":["Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju Sang","family":"Kim","sequence":"additional","affiliation":[{"name":"Incheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea","place":["Incheon, Republic of Korea"],"department":["Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung Woo","family":"Kim","sequence":"additional","affiliation":[{"name":"Incheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea","place":["Incheon, Republic of Korea"],"department":["Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eung Gu","family":"Lee","sequence":"additional","affiliation":[{"name":"Bucheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea","place":["Bucheon, Republic of Korea"],"department":["Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7990-3066","authenticated-orcid":true,"given":"Sung Soo","family":"Jung","sequence":"additional","affiliation":[{"name":"Chungnam National University Hospital","place":["Daejeon, Republic of Korea"],"department":["Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jee Youn","family":"Oh","sequence":"additional","affiliation":[{"name":"Korea University Guro Hospital, Korea University College of Medicine","place":["Seoul, Republic of Korea"],"department":["Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Woo","family":"Kim","sequence":"additional","affiliation":[{"name":"Uijeongbu St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea","place":["Uijeongbu, Republic of Korea"],"department":["Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heayon","family":"Lee","sequence":"additional","affiliation":[{"name":"Eunpyeong St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"],"department":["Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0688-2783","authenticated-orcid":true,"given":"Seunghoon","family":"Kim","sequence":"additional","affiliation":[{"name":"St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea","place":["Suwon, Republic of Korea"],"department":["Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun-Hyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Chungbuk National University Hospital","place":["Cheongju, Republic of Korea"],"department":["Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeonhee","family":"Park","sequence":"additional","affiliation":[{"name":"Daejeon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea","place":["Daejeon, Republic of Korea"],"department":["Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiwon","family":"Lyu","sequence":"additional","affiliation":[{"name":"Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine","place":["Cheonan, Republic of Korea"],"department":["Department of Pulmonary and Critical Care Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun Jung","family":"Kwon","sequence":"additional","affiliation":[{"name":"Konyang University Hospital, Konyang University College of Medicine","place":["Daejeon, Republic of Korea"],"department":["Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Jeong","family":"Jeong","sequence":"additional","affiliation":[{"name":"Dongguk University Ilsan Hospital","place":["Goyang, Republic of Korea"],"department":["Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine","place":["Bucheon, Republic of Korea"],"department":["Division of Allergy and Respiratory Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1200-9892","authenticated-orcid":true,"given":"Hyeon-Kyoung","family":"Koo","sequence":"additional","affiliation":[{"name":"Ilsan Paik Hospital, Inje University College of Medicine","place":["Goyang, Republic of Korea"],"department":["Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganghee","family":"Chae","sequence":"additional","affiliation":[{"name":"Ulsan University Hospital, Ulsan University College of Medicine","place":["Ulsan, Republic of Korea"],"department":["Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun Young","family":"Kyung","sequence":"additional","affiliation":[{"name":"Gachon University Gil Medical Center","place":["Incheon, Republic of 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