A controlled trial of 2-month, 3-month, and 12-month regimens of chemotherapy for sputum-smear-negative pulmonary tuberculosis - Results at 60 months.
Hong Kong Chest Services; Tuberculosis Research Centre; British Medical Services.
American Review of Respiratory Diseases; 1984; 130; 23-28.
Of 1,019 Chinese patients with radiographically active pulmonary tuberculosis but with sputum negative for acid-fast bacilli on 5 initial microscopic examinations who were studied for 5 yr, 364 (36%) had 1 or more initial sputum cultures positive for Mycobacterium tuberculosis . All 1,019 patients were randomly allocated to (1) selective chemotherapy (anti-tuberculosis chemotherapy not being started until the disease had been confirmed to be active); or to (2) daily streptomycin, isoniazid, rifampicin, and pyrazinamide for 2 months; or 3) for 3 months; or to (4) a standard 12-month control regimen. In the 364 patients with 1 or more of their initial sputum cultures positive, the short-course regimens were inadequate, being followed by relapse rates of 32 and 13% respectively, during 60 months, compared with 5% in the control series. In the 655 patients with all their initial cultures negative, the corresponding relapse rates were 11, 7, and 2% in the selective chemotherapy series, 57% of the patients had treatment started during the 60 months because their disease was confirmed to be active.
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