| Comparison of Initial Treatment Regimens Including Short Course Chemotherapy for Pulmonary Tuberculosis Under Programme Conditions |
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Young Pyo Hong, Sung Chil Chang, Sung Chin Kim |
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Korean Institute of Tuoerculosis, The Korean National Tuberculosis Association, Seoul, Korea |
| 단기요법을 포함하는 보건소 폐결핵 초 치료처방 비교 시험성적 |
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홍영표, 장승칠, 김성진 |
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| Abstract |
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Under the programme conditions, 5 daily regimens of initial treatment for pulmonary tuberculosis patients at Health Centres were compared. They were al!ocated at random to:
HPS: isoniazid(24 months) plus PAS (12 months) plus streptomycin(6 months);
HES: isoniazid(24 months) plus ethambutol (12 months) plus streptomycin(6 months);
HEM: isoniazid(24 months) plus ethambutol (12 months) plus morphazinamide(6 months);
9HER: isoniazid plus ethambutol and rifampicin(9 months); and 6HER: isoniazid plus ethambutol and rifampicin (6 months) In all, 1, 339 patients were admitted to the trials ; 145(11%) were subsequently excluded due to various pretreatment reasons, leaving 1, 194(89%) for analysis. There were 233 HPS,
237 HES, 231 HEM, 220 9HER, and 273 6HER. The background factors were remarkably similar for each regimen. Of 1, 194 patients for the main analysis, 260(22%) had terminated their treatment prematurely either before one year of treatment with HPS, HES, and HEM, or before the termination of short course chemotherapy.
As assessed at 12 month, a bacteriologically favourable response was achieved in 96(77%) of 124 HPS; 134(83%) of 162 HES, and 134(81%) of 165 HEM. In short course chemotherapy, a favourable response was achieved in 164(94% ) of 172 9HER and 222 (94%) of 236 6HER at the time of termination. Bacteriological relapse rates calculated by Life Table Method, in the second year of treatment was 3% in HPS, 16% in HES, and 10% in HEM. And the relapse rates after the termination of short course regimens were 3% in 9HER and 14% in 6HER respectively. The therapeutic efficiency was best in 9HER, in regard to bacteriological response, relapse rate, adverse reaction and drop out rate. |
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