肺結核の短期化学療法の評価 (第1報) : 国療化研第19次・20次A研究
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151 pulmonary tuberculosis patients without previous chemotherapy were treated by the regimen indicated in Table 1 and followed up for more than 6 months after stopping the treatment. The characteristic of our regimen is the individualization of the duration of chemo therapy according to the speed of sputum conversion by culture. As some patients converted to negative by culture just at 4 or 5 months of chemotherapy (Table 3), the fixed schedule of 6 months treatment seems unreasonable for such slow converters. In this series, 34 % of the cases were treated for 6 months, 41 % for 7 months and 20 % for 8 months.<BR>Two cases relapsed during the follow up period (Fig. 4 & 5), but if the second case is excluded as it is single isolation of three colonies, the rate of relapse of our series was only 0.7%.<BR>Although extensive and complicated lesions remained at the end of treatment, it is note worthy that radiographic regression continued even after stopping chemotherapy (Fig.6).<BR>The analysis of background factors before chemotherapy in rapid and slow converters revealed that only difference between two groups were amount of discharged bacilli(Fig. 7).<BR>Out of 309 patients initially registered, 46 cases were excluded from the analysis as they were treated for longer than the fixed schedule indicated in Table 1(Table 2): 37 cases due to physicians judgement on unstable radiographic findings, continuous smear positivity, etc. and 9 cases due to patients disagreement to stop chemotherapy<BR>In a. ease excluded from the above analysis because of complicated diabetes, not only bacte riological but also definite radiographic worsening were observed (Fig. 11).<BR>Short course chemotherapy seems to be contraindicated to a patient with severe complications.<BR>Short course chemotherapy in which drugs are discontinued after sputum negativity has been confirmed for 6 consecutive months seems to be very reliable measure for treating tuber culosis patients but the follow up result for longer period seems to be necessary to get the final conclusion.
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