Efficacy of short course anti TB chemotherapy A study in Iran

ABSTRACT

This study was started in March 1983 to treat all the cases of Mycobacterial Tuberculosis with the combination of four bactericidal drugs Rifampin..RIF; Isoniazid. INH; Pyrazinamide..PYZ; and Streptomycin..STR. for a short duration of six months. The four drugs were given for two months and then the two drugs RIF and INH were given for the rest of the four months. Out of 36 patients 20 were males. 16 were females. Age extended from 14- 64 averaging 39 years. 14 were pulmonary TB. 3 were Pulm.TB with cavity.3 were pulmonary TB with Lymphadenopathy. 4 were TB meningitis. 3 were TB empyema. 2 were pulmonary TB with pleural effusion.l was TB abdomen. 2 were TB spine and 4 were TB cervical lymphadenopathy. Socioeconomic status was from poor to middle class; educational level ranged from illitrate to higher secondary level. 11 were treated totally on ambulatory basis and 25 were admitted for a few days to weeks for initial assessment and treatment. Ethnic origin was 21 Irani. 10 Afghani. 2 Pakistani. 3 Indian, Follow up period has been less than 12 months to more than 40 months; During treatment follow up was monthly and after the treatment on yearly basis. Compliance has been excelent. 1 pt. dropped out due to emigration and 1 pt. died during operation for constrictive pericarditis, 1 pt. with meningitis needetd shunt for hydrocephalus. This study once again shows that for Mycobacterial Tuberculous infection whether pulmonary/ extra pulmonary, primary / secondary; cavitory / non cavitory. focal / systemic; ambulatory / hospitallized, the four drugs-six months therapy is quite effective irrespective of economical,educational, age, sex, INH resistance or racial background. Due to good response no extra effort was made to do sensitivity tests. MOTT were not included in the study for which further trials are strongly suggested