Die klinische Bedeutung der Tuberkelbakterienmenge im Auswurf unter tuberkulostatischer Behandlung

Zusammenfassung

Verfasser hat die Angaben der Messung der täglich ausgeworfenen Bakterienmenge zur Beurteilung des Wertes der Zweier- und Dreierkombination verwendet. Er konnte feststellen:

• 1. Das Tempo der Keimzahlverminderung ist bei Anwendung der Dreierkombination signifikant rascher als bei Verwendung der Zweier.

• 2. Bei Anwendung der Zweierkombination schließt sich die Kaverne mit Einlagerung einer größeren Bakterienmenge als bei Dreierkombination.

• 3. Während der Behandlung wurde das Auftreten der Resistenz in Kochnegativ gewordenen Fällen meistens bei Zweierkombination beobachtet.

Summary

The discussion on the value of treatment of cavernous pulmonary tuberculosis with the combination of two or three drugs is still lasting. Author approached this problem from a new standpoint. The daily excretion of bacteria of 40 patients treated with two-resp. three drug combination was measured monthly. The value of treatment was established by the tempo of decreasing of bacterium quantity. For comparison the quotient between the bacterium quantity of two following monthes was determined. The quotient of bacterium quantity measured in the first and second monthes of treatment was 27 in case of three-drug combination and 14 in case of administration of two drugs. In the last two monthes preseeding negativation of sputum the quotient was 48 for three-drug combination and 16 for two-drug combination. These data show that the elimination of bacteria is faster in case of three drug-combination than with two drugs. In the cases treated with two drugs the absolute number of bacteria found in the last positive daily sputum was hihger than in the patients treated with three drugs. The closed tuberculous cavity of patients treated with three-drug combination contains a lesser quantity of bacteria than that of patients treated with two drugs. That explains also, why after two-drug treatment the number of relapses is higher. The development of resistance before the negativation of sputum was oftener in patients with two-drug treatment than with three drug treatment.