[Results of short-term tuberculosis therapy with isoniazid, rifampicin and pyrazinamide].
Short-course chemotherapy of six-month duration with an initial combination of three drugs (isoniazid [H], rifampin [R] and pyrazinamide [Z]) is recommended as the treatment of choice in tuberculosis today. Use of fixed-combination tablet (Rifater) prevents prescription errors by physicians and selective intake by noncompliant patients. It should therefore assist in the prevention of emergence of drug resistance. In a controlled study at a chest hospital in Switzerland involving 261 patients with culture proven tuberculosis, the following two regimens were compared: 1) Six-month therapy (n = 128) with daily Rifater for two months, followed by H and R for four months. 2) Nine-month therapy (n = 133) with H and R daily for nine months, supplemented by ethambutol for the first two months. The two patient groups were comparable except for initial drug resistance (16% vs 8%, p < 0.05). Overall resistance to H was 10%. Five patients had initial resistance to two or more drugs. 227 patients were re-examined 1-8, and on average 4 years after therapy: four patients relapsed after 12, 20, 36 and 90 months. Two patients with initial drug resistance to H later developed resistance to R; both of these, as well as a third relapse patient, were cured with subsequent multi-drug therapy. Despite two and a half years of chemotherapy and repeated surgery, the fourth patient with initial resistance to H and R could not be cured. All relapse patients with initial drug resistance were randomized into the six-month therapy group.(ABSTRACT TRUNCATED AT 250 WORDS)
Brändli
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Zürcher Höhenklink Wald, Faltigberg-Wald.
Dreher
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Morger
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D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage*; D004338:Drug Combinations; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011718:Pyrazinamide / Q000008:administration & dosage*; D012293:Rifampin / Q000008:administration & dosage*; D013997:Time Factors; D014376:Tuberculosis / Q000188:drug therapy*
D000995:Antitubercular Agents; D004338:Drug Combinations; C087181:isoniazid, pyrazinamide, rifampin drug combination; D011718:Pyrazinamide; D007538:Isoniazid; D012293:Rifampin
Ergebnisse der Tuberkulose-Kurzzeittherapie mit Isoniazid, Rifampicin und Pyrazinamid.