再治療肺結核に対するRFP1日450mg連日投与とRFP1日600mg週3回投与の治療効果の比較

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Clinical effects of dialy and intermittent chemotherapy with rifampicin (RFP) were compared in patients with advanced already treated pulmonary tuberculosis. The patients were civided into two groups; group A, 43 cases: RFP were administered 450 mg dialy for 6 months, and group B, 31 cases: RFP were administered 600mg three times a week for 6 months. In 2 cases of group A, three other susceptible drugs were combined with RFP, in 3 cases two drugs and in 17 cases one susceptible drug were also combined. In 2 cases of group B, three other susceptible drugs were combined with RFP, in. 3 cases two and in 8 cases one were also combined. In the remaining cases 20 cases in group, A and 18 cases in group B, no susceptible drug was combined (table 1). The background factors of the cases in group A and group B were as follows: cases older than 40 years of age occupied 81% of group A and 87% of group B, cases with more than 10 years of previous chemotherapy were 40% of group A and 45% of group B, far advanced. cases according to NTRDA classification were 74% of group A and 90% of group B, far advanced mixed type by "Gakken" classification were 28% of group A and 39% of group, B, cases with sclerotic walled cavity were 77% of group A and 94% of group B, bacilli were positive on smear in 79% of group A and 68% of group B (table 2). The rate of sputum conversion was 5 5.9% after 3 months treatment and 62.8% after 6 months in group A, and 46.7% after 3 months and 46.7% in 6 months in group B (table 3). The percent of the cases whose sputa became negative consecutively at the fourth, fifth and sixth months after administration of RFP without combination of susceptible drugs was 28.6% in far advanced mixed type of group A and 0% in group B, and in slighter cases, other than far advanced mixed type, the rate was 54.2% in group A and 46.1% in group B; among cases treated with combination of other susceptible drugs, the rate was 33.8% in far advanced mixed type of group A and 20.2% of group B, and in slighter cases other than far advanced mixed type, the rate was 82.5% in group A and 71.4% in group B (table 4). Chest roentgenogram showed improvement in 18% of group A and 18% of group B after 6 months treatment (table 5). Adverse effects were observed in 18.5% of group A; transient elevation of S-GOT and/or S-GPT in 6 cases, nausea and vomiting in 1 case, heart brun in 1 case, although, the administration of RFP was continued except transient intermission in 1 case. In group B, advers effects were observed in 9.3%; elevation of S-GOT and S-GPT in one case (the administration of RFP was stopped in this case), transient elevation of GPT in one case, and skin eruption and psychological disturbance in one case (the dose of RFP was reduced in this case). In conclusion, the therapeutic effects of daily treatment with 450mg RFP was slightly more effective than those of intermittent treatment with 600mg RFP three times a week.
一般社団法人日本結核病学会の論文

再治療肺結核に対するRFP1日450mg連日投与とRFP1日600mg週3回投与の治療効果の比較

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