Hong Kong Study of 6-and 9- Month Regimens of Daily and Intermittent Streptomycin, Isoniazid and Pyrazinamide for Pulmonary Tuberculosis
A comparison has been made between 6-and 9-month regimens of streptomycin, isoniazid and pyrazinamide given daily, 3 times a week or twice a week from the start of chemotherapy, in the treatment of newlydiagnosed, smear positive pulmonary tuberculosis in Chinese patients.
At 6 months the twice weekly regimen was marginally inferior to the two other regimens in that 5 (4%) of 126 patients with drug-sensitive strains pretreatment had an unfavourable bacteriological status compared with only 2 (1%) of 141 on the 3 times weekly and none of 137 on the daily regimen. Of a total of 211 patients treated for 9 months, only 1 of 74 on the twice weekly regimen relapsed bacteriologically between 6 and 9 months.
The bacteriological relapse rates in the first 9 months of follow up after 6 months’ chemotherapy were 17% on the daily, 21% on the three times weekly and 18% on the twice weekly regimen, and after 9 months’ chemotherapy they were 5%, 5% and 4% respectively. All the relapses were with strains sensitive to isoniazid and streptomycin, and 63% occurred in the first 3 months after the end of chemotherapy.
The patients with drug-resistant strains pretreatment fared less well. One third of them had an unfavourable bacteriological status at 6 months. However, the relapse rates after the end of chemotherapy were similar to those for patients with sensitive strains pretreatment.
KeywordsRelapse Rate Pulmonary Tuberculosis Daily Regimen Calcium Gluconate Weekly Regimen
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