[Survey of the initial treatment of pulmonary tuberculosis in West Germany. A study by the German Central Committee for the Prevention of Tuberculosis].
1405 adult patients were selected for assessment who had been newly notified in the years 1986/87 with confirmed diagnosis of active progressive pulmonary tuberculosis who required treatment. Of these, 83.5% excreted tubercle bacilli in the sputum; radiographic lung cavities were confirmed in 53.6%, and 859 (61.1%) had a concomitant disease. 1173 patients (94.2%) were hospitalized for initial treatment and only 232 (5.8%) received outpatient treatment. The median duration of the hospital stay was 12 weeks. Isoniazid and rifampicin were prescribed in 96% and 93% patients, respectively, mostly all the time, ethambutol in 75% initially and in 50% throughout, streptomycin in 50% initially. Three or four drug regimens including pyrazinamide in the initial phase were employed in 76% of the patients. Premature discontinuation of therapy for different reasons was noted in 135 patients (9.5%). Of these, treatment was discontinued in 59 (4.2%) due to death; 37 (2.6%) patients died due to tuberculosis. Adverse reactions were observed in 193 patients (13.7%); 0.3% of the patients discontinued chemotherapy because of toxicity. The duration of chemotherapy was between 9 and 12 months in the majority of patients; 30%, however, were treated for more than 12 months. The chemotherapy of 6-months duration was performed only in about 10% of treated patients. Among the patients who completed the treatment, this proved effective in 98%. Although the majority received initially the rational chemotherapy with a three or four drugs regimen, it is concluded that the inpatient stay and the outpatient duration of chemotherapy in the routine clinical practice is too long, therapy control is insufficient.
Zierski
M
M
Hoffmann
O
O
Bornhardt
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
D000995:Antitubercular Agents
Erhebungen zur Erstbehandlung der Lungentuberkulose in der Bundesrepublik Deutschland. Eine Studie des Deutschen Zentralkomitees zur Bekämpfung der Tuberkulose.