Tuberculosis Chemotherapy Centre, Madras
(1964)
A Concurrent Comparison of Intermittent
(Twice-Weekly) Isoniazid plus Streptomycin
and Daily Isoniazid plus PAS in the Domiciliary
Treatment of Pulmonary Tuberculosis.
Bulletin of the World Health Organization, 31 (2).
pp. 247-271.
ISSN 00429686
Abstract
Previous reports from the Tuberculosis Chemotherapy Centre, Madras, have
established that ambulatory treatment of pulmonary tuberculosis with the combination
of isoniazid and PAS, administered daily, yields satisfactory results. However,
in the usage of any unsupervised regimen, reliance must be placed on the co-operation
of patients in self-administering their drugs. Irregularities in drug-taking, which
are not uncommon, may lead to unfavourable therapeutic results; this might be
avoided by supervised administration of the drugs. Daily supervision is clearly
impracticable in developing countries but regimens in which the drug is administered
intermittently-say, twice a week or less frequently-are, if effective, more likely
to gain general application.
This paper presents the results of a controlled study of a fully supervised intermittent
regimen of isoniazid (12.5-16.1 mg/kg body-weight, orally) plus streptomycin
(injected in a uniform dose of I g), given together twice weekly, compared with a
standard, unsupervised, daily, oral regimen of isoniazid (3.7-63 mg/kg body-weight)
plus sodium PAS (0.2-0.3 g/kg body-weight), given in two doses. The intermittent
regimen was at least as effective as the standard oral regimen, and although the
incidence of temporary giddiness in patients receiving this regimen was rather high,
this did not appear to have any long-term importance nor did it appear unduly to
affect the co-operation of the patients. These encouraging findings suggest a possible
change in the orientation of drug-administration for tuberculosis in developing
countries.
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