Rifampicinで6カ月以上治療した既治療肺結核症の長期間の観察
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Therapeutic effects of treatment with rifampicin (RFP) for more than 6 months were ob served, bacteriologically in 53 patients with pulmonary tuberculosis for 48 months. These cases. had been treated previously for tuberculosis including chemotherapy and surgical treatment, and showed positive bacilli within 3 months before starting RFP treatment.<BR>The results were summarized as follows:<BR>1) The negative conversion rate of tubercle bacilli in sputum after starting RFP treatment reached its peak (73.1%) at 3rd month, then fell down to 69. 8% at 6th month. The bacilli negativity after the 7th month was approximately 70% including cases with RFP switched again. to RFP treatment thereafter.<BR>2) It was hardly possible to obtain persistently negative bacilli among cases who failed to convert to negative after the use of RFP, eventhough the regimen of chemotherapy was changed. to another combination of anti-tuberculous drugs or RFP was tried again thereafter.<BR>3) The negative conversion rate of bacilli in sputum related to the amount of bacilli dis charge before starting treatment; the rate was nearly 100% in smear negative culture positive cases, and it was approximately 70% in smear and culture positive cases.<BR>4) The negative conversion rate was higher in non-cavitary cases than in cavitary cases.<BR>5) Among cases showing consecutively negative bacilli for 3 months and longer, before terminating the use of RFP, nearly all cases showed persistently negative status during the follow-up. Among cases showed positive bacilli within 3 months before terminating the use of RFP, only few case converted to negative by the use of other regimen of chemotherapy, and. the majority of negative converted cases reconverted to positive thereafter.<BR>6) The bacteriological relapse among cases converted to negative by the use of RFP was, observed until 17th month, and not a single case relapsed therreafter. It is advisable to contiune chemotherapy for at least 18 months after negative conversion of bacilli in sputum in the case of retreatment.
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