[Chemotherapy with isoniazid and rifampicin for pulmonary tuberculosis].
Two-drug regimen of chemotherapy with isoniazid and rifampicin for pulmonary tuberculosis is the one of the standard methods of treatment for active pulmonary tuberculosis in Japan since 1996, while ATS/CDC and WHO/IUATLD recommended the three-drug or four-drug regimen containing chemotherapy pyrazinamide unless the prevalence of drug resistance, among new tuberculosis cases is low. We sent a questioners of 141 tuberculosis centers in Japan to investigate the rate of each standard chemotherapy regimen employed and reasons for selecting the two-drug regimen in each center. Of 3840 newly diagnosed cases in the 57 centers, 47.4% were treated with the four-drug regimen and 37.1% with the three-drug regimen, and two-drug regimen was employed in only 2.6%. Sputum smear-negative status was the major reason for selecting the two-drug regimen of chemotherapy. Though the two-drug regimen was used in few cases, taking into account the prevalence of primary resistance to isoniazid in Japan in 1997 was 4.4%, it was concluded to discontinue recommending the two-drug regimen as one of standard methods of treatment for pulmonary tuberculosis.
Kawakami
Kenji
K
Department of Respiratory Disease, Kawatana National Hospital, 2005-1, Shimogumi-go, Kawatana-cho, Higashisonogi-gun, Nagasaki 859-3615, Japan. kkawamam@kwthp.hosp.go.jp
D000995:Antitubercular Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage*; D007564:Japan; D011718:Pyrazinamide / Q000008:administration & dosage; D012015:Reference Standards; D012293:Rifampin / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
D000995:Antitubercular Agents; D011718:Pyrazinamide; D007538:Isoniazid; D012293:Rifampin