二次薬治療における1剤,2剤および3剤方式の効果の比較

抄録

298 pulmonary tuberculosis patients who were discharging bacilli continuously regardless previous long term chemotherapy were treated for 6 months by kanamycin, ethionamide and/or pyrazinamide in single, double or triple drug regimen. Besides 221 patients had been exempted from the trial due to various reasons mentioned in Fig.1. The assignment of the drug was not at random but a drug or a combination of drugs which had not been prescribed previously were allocated to individual patient. Streptomycin, isoniazid or its derivatives, PAS or sulfonamide which had been proved to be of no effect was also administered to the most of patients simultaneously with the drugs to be assessed. The regimens used were indicated in Table 2. The analysis of the background foctors reveale d that the triple drug regimens were slightly advantageous over other kinds of regimens (Fig.1 and 2). Table 3, Fig.3, 4, 10 and 11 indicate that the more the number of the sensitive drugs administered simultaneously increase, the higher is the clinical efficacy of the regimen as to the rate of sputum conversion, the rate of reappearance of bacilli after the consecutive negative three months, and the rate of regression of cavitary and noncavitary lesion. The triple drug regimen, especially the combination of kanamycin, ethi o namide and cycloserine was the most potent among the regimens assessed in the present trial. The relationship between the rate of drug resistance, doubtful drug resistance and sensitivity on the one hand and a trend of the change in the number of bacilli discharged on the other was demonstrated in Fig.6, 7 and 8. The effect of the accompanying drugs on the appearance of resistance to kanamycin, ethionamide and cycloserine was analysed in Fig.9.