| A clinical effect of retreatment by prothionamide, cycloserine, para-aminosalicylic acid, streptomycin(kanamycin or tuberactinomyc-in) on pulmonary tuberculosis. |
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Cheol Shick Shin, Young Jae Im, Young Jun Kim, Seok Shin Koh, Moon Shik Kim |
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National Kongju Tuberculosis Hospital, Kongju, Korea |
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| Abstract |
Background
In the management of patients whose primary chemotherapy has failed, very careful assessment is essential. It is important to find out as accurate a chemotherapy history as possible.
Preferably it should contain the drugs which has never used before. The present report concerns the results of retreatment of pulmonary tuberculosis patients treated at National Kongju Tuberculosis Hospital.
Methods
A retrospective study was made through the regular follow-up of 112 smear positive cases,
who were treated by four-drug regimen between July 1985 and June 1990. Four drugs were, namely prothionamide, cycloserine, para-aminosalicylic acid and streptomycin (kanamycin or tuber-actinomycin). The duration of follow-up was over one year.
Results
1) Out of 112 cases with positive sputum AFB smear, 72 (64%) achieved the negative conversion.
2) Among the 72 patients, 85% achieved negative conversion within 3 months after treatment.
3) When the duration of patient’s illness was less than 2 years, 2 to 4 years and more than 5 years,
the favourable response to retreatment was 86%, 62% and 54%, respectively.
4) When the number of sensitive drugs was 4, 3, 2 and 1, the favourable response rate was 74%, 68%, 39% and 0%, respectively.
Conclusion
The shorter the duration of patient’s illness was, the larger the number of sensitive drugs was. And the larger the number of sensitive drugs was, the better the result of treatment was.
Thus it is very crucial to successfully treat newly discovered patients with adequate regimens and proper case-holding. |
| Key Words:
Pulmonary tuberculosis, Retreatment chemotherapy, Four-drug regimen, Clinical effect |
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