The efficacy of short course chemotherapy for tuberculosis in Jamaica - abstract

ABSTRACT

The use of rifampicin has reduced the duration of therapy in tuberculosis considerably. Short course chemotherapy aims at reducing the dutation of therapy while maintaining optimum efficacy. The regime used in this study was Isoniazid (H) 300 mg, Rifampicin (R) 450-600 mg and Pyrazinamide (Z) 800-1200 mg as a single oral dose daily with Streptomycin (S) 1 gm intramuscularly daily for two months as hospitalized therapy, followed by Isoniazid 300 mg and Thiacetazone (T) 150 mg daily for six months after discharge. Between 1979 and 1981, 38 cases with AFB positivity were treated with 2SHRZ/6HT. There were 15 males and 23 females with a mean age of 31 years. In 37 patients, cough was the predominant symptom, with expectoration in 14. Loss of weight was seen in 21 and fever in 15. In all cases, there was radiological evidence of cavitation in the upper lobes. Therapeutic evaluation showed weight gain and return of appetite within two months. Sputum conversion to culture negatively was seen in 1 to 14 weeks with a mean of 46 days for males and 55 days for females. In 17 cases, there was a transient rise in uric acid level, a side-effect of Pyrazinamide, with no clinical consequence. One case of arthralgia was seen. We recommend the 2SHRZ/6HT regime as the most effective, and the cheapest short duration therapy for tuberculosis in Jamaica (AU)