[Intensive chemotherapy tolerance in old patients with pulmonary tuberculosis]. / Perenosimost' intensivnoi khimioterapii bol'nymi starcheskim tuberkulezom.

In accordance with the WHO recommendations, the intensive stage of chemotherapy was performed in 100 patients aged 60 to 87 years who had pulmonary tuberculosis. Most (n = 78) patients successfully completed this stage and the remaining 22 patients developed intractable adverse reactions and they had to receive individual chemotherapy regimens. In addition, 27 more patients had adverse reactions that could be eliminated by routine methods, without discontinuing standard treatment. The distinctive feature of intractable reactions were their occurrence within the first 10-20 days after the onset of treatment, they were markedly toxic and allergic and appeared as changes in some organ systems. They are most likely to develop in patients with significant cardiovascular diseases (hypertensive disease, coronary heart disease) accompanied by pronounced focal and diffuse myocardial changes, as evidenced by ECG and in those with signs of prior myocardial infarction. Correctable adverse reactions generally occur in the final period of intensive chemotherapy, they are mainly toxic and differ from intractable reactions of less extent.

[Efficiency of an intensive stage of chemotherapy for tuberculosis in elderly and senile patients]. / Effektvnost' intensivnogo étapa khimioterapii tuberkuleza u lits pozhilogo i starcheskogo vozrasta.

A hundred new cases of active pulmonary tuberculosis whose age was 60 to 87 years were treated by the intensive chemotherapy regimen recommended by the WHO. Most (n = 78) patients satisfactorily tolerated the intensive stage, fully completed the regimen, and made up a study group (Group 1). Group 2 comprised the remaining 22 patients who had, due to its poor tolerance, to transfer to their individual regimen. The higher incidence of significant cardiovascular diseases in Group 2 patients is the only significant difference between these two identified groups. The advantages of the standard chemotherapy regimen are the more rapid elimination of symptoms of tuberculous intoxication; the earlier and more frequent disappearance of Mycobacterium tuberculosis from the sputum even with the primary drug resistance of the causative agent; as well as a more frequent closure of decay cavities. The findings make it possible to recommend a wider use of the standard intensive chemotherapy regimens for elderly and senile patients with tuberculosis.