Isoniazid with thiacetazone (thioacetazone) in the treatment of pulmonary tuberculosis in East Africa—Fourth investigation: The effect of increasing the dosage of isoniazid

摘要: Summary This report gives the results of a controlled study for 12 months of: o (a)the effects increasing dosage isoniazid from 300 mg. to 450 in combination with thiacetazone 150 mg., (b)the role an initial two hospital compared out-patient treatment start, (c)the value routine surprise home visits per month no such visits. Between February 1963 and June 1964, 373 patients were allocated at random eight subgroups formed (a), (b) (c) above. The pretreatment findings similar most respects they have therefore been combined make following comparisons: A.of drug regimens TH300 series: Thiacetazone plus daily. TH450 pyridoxine 6 B.of in- IN An followed by treatment. OUT Out-patient start. C.of visiting HV Two each month. No Results are presented 251 who had isoniazid-sensitive strains tubercle bacilli complied clinical criteria admission. Fourteen died, nine (three TH300, six TH450) active tuberculosis, three (one unestablished cause but one (TH450), without evidence non-tuberculous cause, (TH450) death was attributed toxicity. sputum culture negative 81% 77% 79% 68% respectively, statistically non-significant differences. At 71% 17 19 positive cultures isoniazid-resistant strains. In second 67% 78 resistant series, as 83% 89 series. sensitivity tests yielded emergence resistance both geometric mean 29 series 1·07 2·25 μg./ml. respectively (P=0·002). status classified mainly on basis 10, 11 months; 109 favourable 102 TH450, difference; 76% 110 101 status, 74% 72% status. first four (3%) 159 in-patients defaulted did 75 out-patients (OUT/HV series), 13 (15%) 88 (OUT/No series); this difference attains statistical significance (P Drug toxicity reported (2·5%) side-effects 360 patients, (0·3%) reactions possibly drugs. It is concluded (a) that single daily dose not more effective than dose, little, if any, influence response treatment, reduced default early started out-patients.