Comparative trial of isoniazid in combination with thiacetazone or a substituted diphenylthiourea (SU1906) or PAS in the treatment of acute pulmonary tuberculosis in east africans

摘要: Summary One hundred and fifty six patients with acute extensive pulmonary tuberculosis were allocated at random to treatment isoniazid 200 mg./day, together either thiacetazone 150 mg./day (the TBl/H series), or the substituted diphenylthiourea SU1906 2 g./day DPT/H PAS (sodium salt) 10 PH series). The chemotherapy was prescribed for one year series, being given in hospital first months; series studied only months when it found that bacteriological results this unsatisfactory. analysed two groups, main analysis on 127 (43 TBl/H, 46 DPT/H, 38 PH) organisms sensitive initially PAS, subsidiary 29 (8 9 12 resistant isoniazid, both drugs. Among analysis, there 1 early tuberculous death l non-tuberculous deaths due necrosis of liver atributed toxicity. Radiographic deterioration leading change occurred patient each series. Substantial clinical radiographic progress made all three however, showing a smaller average gain weight than In end negative culture obtained 77 per cent 51 87 At twelve corresponding figures 88 Isoniazid-resistant strains 6 9l positive cultures patients; patients, 100 16 patients. organisms, 7 8 had before months. Of reasons these favourable findings are discussed; many appear have consisted mixture organisms. groups combined, definite toxic reactions 4 total neccessitating treatment; neutropenia below 1,000 neutrophile cells c.mm. developed, severe hypersensitive reaction intractable vomiting. Three 55 (in months); exfoliative dermatitis, lichen planus neutropenia. 50 drug reactions; died from developed mental confusion followed by hepatitis. Detailed toxicity studies as routine haemoglobin level remained stationary over twelve-month period but increased Serum protein estimations showed similar increase initial low serum albumen/globulin ratio No abnormal changes observed any bilirubin, thymol turbidity alkaline phosphatase estimations. Urine tests tendency proteinuria urobilinogenuria series; neither finding appeared be consequence. An assessment status months, based primarily results, including chemotherapy. classed 72 79 doubtful 5 PH, unfavourable 21 similar. It concluded (150 mg./day) efficacy sodium (10 g./day) companion (200 mg./day), producing sputum conversion preventing emergence isoniazid-resistant strains. an earlier pilot trial (also reported here) also more dose used present trial. Caution is advised introducing plus widespread use. Further trials now progress, designed discover, larger numbers lowest effective dosage acceptability combination out-patients.