Controlled trial of 6-month and 8-month regimens in the treatment of pulmonary tuberculosis: The results up to 24 months |
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| Affiliation: | 1. Child Health Evaluative Sciences and Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada;2. Harvard T.H. Chan School of Public Health, Department of Global Health and Population, United States;3. Harvard T.H. Chan School of Public Health, Harvard Center for Population and Development Studies, United States;4. Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, United States;5. Harvard T.H. Chan School of Public Health, Department of Epidemiology, United States;1. Community Health Department, St. Stephen''s Hospital, Tis Hazari, Delhi 110054, India;2. Professor, Community Health Department, St. Stephen''s Hospital, Tis Hazari, Delhi 110054, India;3. Chest (T.B.) Clinic, Lok Nayak Hospital, New Delhi, India;4. Department of Resp. Medicine & TB, Rajan Babu Institute of Pulmonary Medicine & TB, Delhi, India;1. National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China;2. WHO Collaborating Center for Tropical Diseases, Shanghai, People’s Republic of China;3. National Center for International Research on Tropical Diseases, Shanghai, People’s Republic of China;4. Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People’s Republic of China;1. Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand;2. Drug-Resistant Tuberculosis Research Fund, Siriraj Foundation, Bangkok, Thailand;1. Department of Infectious Diseases, Kameda Medical Center, 929 Higashicho, Kamogawa, Chiba 2968602, Japan;2. Department of Infectious Diseases, Narita Red Cross Hospital, 90-1, Iidacho, Narita, Chiba 2868523, Japan;3. Department of Laboratory Medicine, Kameda Medical Center, 929 Higashicho, Kamogawa, Chiba 2968602, Japan |
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| Abstract: | Four short-course antituberculosis regimens allocated at random were studied; (1) streptomycin, isoniazid and rifampicin given daily for 6 months; (2) these 3 drugs plus pyrazinamide given daily for 2 months, followed by twice-weekly streptomycin, isoniazid and pyrazinamide; (3) a regimen which differed from regimen 2 only in that ethambutol replaced pyrazinamide, and (4) streptomycin, isoniazid, rifampicin and pyrazinamide given 3 times a week for 4 months, followed by streptomycin, isoniazid and pyrazinamide twice a week. The last 3 regimens were given for 6 or 8 months by random allocation.All except 1 of 680 patients with drug-sensitive tubercle bacilli pretreatment had a favourable bacteriological response during chemotherapy. The relapse rates during the period from the end of chemotherapy up to 24 months in the non-ethambutol series were 6–7% following the 6-month regimens and 1–3% following the 8-month regimens. However in the ethambutol series, 23 % of 84 patients had a bacteriological relapse after 6 months of chemotherapy, and 10 % of 84 after 8 months. All except 1 of the patients with strains initially resistant to either isoniazid or streptomycin had a favourable bacteriological response during chemotherapy. Of the patients with strains resistant to both drugs, all those in the ethambutol series had a favourable bacteriological response during chemotherapy, but the results were not so good in the other series. Relapse after the end of chemotherapy among patients with initially resistant strains was commonest in the ethambutol series; it was not associated with the emergence of further drug resistance in any of the series. |
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