[Present status and future problem of chemotherapy for tuberculosis].
This symposium was carried out to know present status of chemotherapy of tuberculosis in Japan, compared with that of several developed country and to discuss the future problem. Main results are as follows: 1) The number of original treatment cases who finished the treatment within the standard duration was few (22.4%), and the duration varied from 3.49 to 1.29 years by prefecture. It was noted that the districts where the treatment period were longer had higher rate of INH single treatment, therefore it is necessary to clarify whether INH single treatment in those cases would have beneficial effect or not. 2) The average duration of admission in developed countries was extremely short, namely 69 days in Netherlands and 23 and 18 days in U.K., U.S.A. respectively compared with 182 days in Japan. It is hoped that the consensus on definite criteria of infectivity of tuberculosis patients after treatment could be established. 3) The prognosis of original treatment cases with far advanced X-Ray findings was examined by cooperative study unit on chemotherapy of tuberculosis of the national sanatoria (CSUT) and nearly thirty percent of therapeutic failure including the cases whose tubercle bacilli in sputum did not convert to negative (3.1%), with bacterial relapse (1.5%), death by tuberculosis (10.5%) and respiratory failure with more than third degree of H-J criteria (11.1%) was observed. This high rate of death by tuberculosis suggested that further studies on treatment method for far advanced cases would be necessary. 4) The follow up study during five years on the duration of treatment for retreatment cases was carried out by the Tuberculosis Research Committee in Japan. The rate of therapeutic failure including cases whose tubercle bacilli did not convert to negative (11.1%), with bacteriological relapse (2.4%), death (7.2%) was as high as 18.3%. The rate of therapeutic failure was particularly high (62.5%) in cases resistant to rifampicin. It is hoped that more cautious treatment for original treatment cases would be needed to prevent treatment failure and new anti-tuberculosis drugs without cross resistance to existing drugs would urgently be developed.
D000328:Adult; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000401:mortality; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology