1979 Volume 54 Issue 9 Pages 467-472
As our results of 12 month short-course chemotherapy were good, studies on 6-9 month short-course chemotherapy have been started for newly diagnosed smear-positive cavitary tuberculosis patients since 1976.
During initial 3 months SM, INH and RFP are administered daily (Table 1). At the end of the third month, the next regimen is determined according to the results of a culture taken at the end of the first month. If this culture is positive, SM twice weekly with INH and RFP daily is given for 3 months, which is then followed by INH and PAS for 3 months and chemotherapy is terminated (regimen I). When the culture is negative, the regimen is changed to INH and RFP for the next 3 months. At this time, 6 months after starting chemotherapy, the regimen is changed accord ing to the presence or absence of cavities. In cases with cavities, INH and PAS is administered for 3 months (regimen II), and for non-cavity cases chemotherapy is either terminated at this point or INH alone for another 3 months (regimen III). If side effects to SM or PAS appear, EB is used in place of SM or PAS.
Among 255 cases, 70 were dropped out during 6-9 month treatment period (Table 2).
In 185 cases administered SM·INH·RFP, the negative conversion of sputum by culture was seen in 84% at the second month and in all cases at the fourth month (Fig. 1). Moderate to marked improvement of radiographic findings was seen in 76% when the therapy was completed (Table 4). Among 185 cases, there 52 were dropped out during the follow-up period (Table 5).
In 133 cases who were followed up for more than 6 months after the completion of the therapy, a further radiographic improvement was seen in 20% of cases after stopping chemotherapy (Table 7). This fact shows that when chemotherapy is carried out with a regimen containing the bactericidal drugs such as INH and RFP, there is no need to continue chemotherapy to the radiographic therapeutic target point.
Only 2 cases (1.5%) showed radiographic and bacteriological relapses at 8th month after stopping chemotherapy (Table 7).
Six to nine month short-course chemotherapy for newly diagnosed pulmonary tuberculosis patients with SM·INH·RFP showed excellent results.
