肺結核の短期化学療法に関する研究 ＩＩＩ Ｐｙｒａｚｉｎａｍｉｄｅを加えた初期強化短期療法:Pyrazinamideを加えた初期強化短期療法 A STUDY ON SHORT-COURSE CHEMOTHERAPY FOR PULMONARY TUBERCULOSIS (REPORT3)
A short-course chemotherapy with SM, INH and REP supplemented for the first two months with Pyrazinamide (PZA) have been made since 1979.<BR>Eighty two cases bacilli positive newly diagonosed pulmonary tuberculosis were subjected to the study, and 12 (15%) were dropped out due to adverse reactions by PZA (Table 7).<BR>The rate of negative conversion of bacilli in sputum as the second months after starting chemotherapy was 95.7%, which was significantly higher than that in cases treated with the SM·INH·RFP regimen as previously reported (Fig. 1).<BR>The difference in the results was particularly remarkable in cases with large amount of bacilli discharge at the start of treatment; the negative conversion rate was 94.1% in PZA containing group and 78.6% in SM·INH·REP group. (Table 3)<BR>As shown in table 4, 19 out of 70 cases were dropped out from the follow-up study, and in 31% of the remaining 51 cases, a further radiographic improvement was seen after completing chemotherapy.<BR>Only one case (2%) showed radiographic and bateriological relapse at the 4th months after completing chemotherapy. (Table 5, 6)<BR>In 47% cases using PZA, serum uric acid concentration was elevated during the period of treatment, but no correlation was found between subjective arthralgia and elevation of serumuric acid level.<BR>The above mentioned experience showed that the higher and faster sputum negative conversion with less chance of relapse was obtained by the initial intensive chemotherapy with SM·INH·REP adding PZA for the first two months.<BR>Moreover, the regimen containing pyrazinamide did not produce undue toxicity.<BR>This regimen might be successful even for cases with primary resistance to INH.
結核 58(9), 459-464, 1983