EBを含む多剤併用療法を1年間実施した肺結核初回治療患者の2年目までの追及
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The bacteriologic and radiologic results after 1 year of controlled trials of threeregimens for previously untreated patients with pulmonary tuberculosis were reportedalready (Vol.46, No.8). In the present paper, we report the follow-up results up to 2 yearsafter 1 years treatment of the following regimens: EB0-Streptomycin 1g twice weekly, INH 0.4g daily and PAS 10g daily for 1year (Standard regimen) EB2-Standard regimen of SM, INH and PAS with addition of EB 750mg twiceweekly for 1 year EB7-Standard regimen of SM, INH and PAS with addition of EB 750mg daily for 1 year All patients had cavities and sputum positive on microscopy. 287 patients were included in the study, and 59 had to be excluded because of theprimary drug resistance, etc. Out of the remaining 228 patients, 74 (32.4%) had defaultedfrom the allocated regimens (Table 1).<BR>In the group EB7, 92.0% of 80 patients were evaluated “favourable” or “probablyfavourable” at 12 month, compared with 86.9% in the group EB0 and 82.0% in the groupEB2. This difference was not statistically significant (Table 3). In the group EB7 only 1patient (1.3%) was evaluated “unfavourable” at 12 month compared with 6 patients (8.8%), in the group EB0. This difference was statistically significant at 5% level.Change of regimen because of side-effects was recorded in 5 patients (6.7%) in the group, EB7 and 11 patients (15.3%) in the group EB2 compared with 3 patients (4.3%) in thegroup EB0. This difference was not significant.<BR>In the evaluation at 18 and 24 months, there was no significant difference in the ratio of“favourable” among the three regimens (Tables 4 & 5).<BR>In the group EB7 only 2 patients were evaluated “unfavourable” during 2 yearsincluding 1 years period of allocated treatment, compared with 11 patients of“unfavourable”, “probably unfavourable” and bacteriological or radiological deteriorationin the group EBo. This difference was statistically significant at 1% level (Table 6). In caseswith multiple cavities or abundant bacilli in sputum, the difference between EB0 and EB7was definite (Table 7).<BR>It was concluded therefore:<BR>1) Multiple drug chemotherapy for previously untreated pulmonary tuberculosispatients reduced the number of unfavourable cases, while defaulters due to toxicityof drugs showed trend to increase.<BR>2) In far advanced cases, multiple drug chemotherapy, is worthy of consideration.
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