A controlled comparison of streptomycin plus pyrazinamide and streptomycin plus PAS in the retreatment of patients excreting isoniazid-resistant organisms.
Velu, S.; Dawson, J.J.Y.; Devadatta, S.; Wallace Fox; Kulkarni, K.G.; Mohan, K.; Ramakishnan, C.V.; Stott, H.
Tubercle; 1964; 45; 144-159 and Indian Journal of Tuberculosis; 1965; 12; 72-86.
A controlled comparison has been made of streptomycin plus pyrazinamide (46 patients) and streptomycin plus PAS (36 patients) in the retreatment of patients with pulmonary tuberculosis. The patients had either failed to attain bacteriological quiescence on isoniazid alone or had relapsed bacteriologically after attaining quiescence; all were excreting strains of tubercle bacilli resistant to isoniazid but sensitive to streptomycin and PAS at the start of the trial.
The disease status at 1 year was assessed in 41 patients on pyrazinamide and 24 on PAS, and of these, 29 (71%) and 12 (50%) respectively, had bacteriologically quiescent disease.
Seven patients (2 on pyrazinamide, 5 on PAS) had their treatment terminated for toxicity, 1 due to a pyrazinamide polyarthritis, 2 on account of hypersensitivity to PAS, and 4 (1 on pyrazinamide, 3 on PAS) because of streptomycin toxicity. Nine patients (2 on pyrazinamide, 7 on PAS) because unco-operative and stopped treatment, and 2 patients(on pyrazinamide) died, 1 of a non-tuberculous condition.
Thus, streptomycin plus pyrazinamide was slightly more effective therapeutically than streptomycin plus PAS and was not more toxic or less acceptable to the patients.
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