The Quintuple Combined Chemotherapy with Streptomycin, Isoniazid, Pas, Cycloserine and Kanamycin in ChronicTreatment-Failure Pulmonary Tuberculosis

Abstract

Most fresh cavities in pulmonary tuberculosis are curable by the double or triple combined chemotherapy with isoniazid and PAS or with streptomycin, isoniazid and PAS. Management of the chronic, active, treatment-failure case with tubercle bacilli resistant to multiple drugs continues to be a major problem in tuberculosis hospitals. Disappointing results have attended the trials of many secondary drug regimens. A high rate of sputum “conversion” was obtained by the treatment of such case with the quintuple combined chemotherapy with streptomycin, isoniazid, PAS, cycloserine, and kanamycin, although double or triple chemotherapies remained ineffective for such case. The success of sputum converison was observed in patients whose tubercle bacilli remained resistant to either of two drugs, streptomycin or isoniazid, and not in those whose tubercle bacilli were resistant to both the drugs or more.