ETHAMBUTOL COMBINED WITH STREPTOMYCIN AND ISONIAZID FOR THE ORIGINAL TREATMENT CASES OF PULMONARY TUBERCULOSIS

Abstract

The study deals with clinical effects of ethambutol (EB)-streptomycin (SM)-isoniazid (INH)versus paraaminosalicylic acid (PAS)-SM-INH in original treatment of pulmonary tuberculosis.
The cases with positive tubercle bacilli were allocated at random for two reg i m ens; EBSMINH group including 50 cases and PAS-SM-INH group including 46 cases after exclusion of those which had been proven as primary resistant cases or discontinued treatment by side effect.
EB was administered 1 gm daily in one dose for 60 days and 0.75gm daily for the following period until 6 months, SM was injected 1 gm twice weekly, and INH was given 0.4 gm daily in two divided doses while PAS was administered 10gm daily dividing after each meal.
The background factors of cases in each group were almost similar.
The clinical effects of the regimens were compared according to the rate of improvements of chest radiograms and bacilli conversion rate in sputa. No statistically significant difference was detected between both regimens: that is, the rate of improvements of basic lesions were 66% in EB group and 70% in PAS group after 3 months, 86% and 88%, respectively, after 6 months; the rate of improvement of cavities with nonsclerotic walls were 90% in EB group and 86% in PAS group after 6 months: and tubercle bacilli in sputa converted to negative in 78% after 3 months and 94% after 6 months by EB-SM-INH, and in 83% and 88%, respectively, by PAS-SM-INH.
No side effect was observed in EB group, while 7 cases in PAS group had adverse reactions including 4 cases of gastroenteric disturbances and one case of allergic reaction due to PAS and two cases due to SM including each one case of tinnitus and hypoaesthesia of face.
The authors concluded that EB will be given as a substitute of PAS for the original treatment cases of pulmonary tuberculosis treated by SM-INH-PAS if any adverse reactions by PAS have been observed.