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Short-course chemotherapy for pulmonary tuberculosis with a rifampicin-isoniazid-pyrazinamide combination tablet.

Abstract
The effectiveness of a tablet containing a combination of rifampicin, isoniazid and pyrazinamide (Rifater; Mer-National) in the treatment of pulmonary tuberculosis was examined by comparing it with a previously evaluated four-drug regimen. Of 150 black goldminers with a first case of pulmonary tuberculosis, 69 were randomly allocated to receive the combination tablet (RHZ), 5 tablets per day on weekdays for 100 treatment-days, and 81 the four-drug regimen (streptomycin, rifampicin, isoniazid and pyrazinamide) (RHZS). Non-compliance was detected in 42% of the RHZ group and in 16% of the RHZS group. Two patients in the RHZ group and 4 in the RHZS group had to have their treatment altered because routine investigations revealed drug-resistant mycobacteria. Treatment was unsuccessful in 10 patients in the RHZ group, with 4 men failing to complete the regimen and being lost to follow-up, 3 cases of failure of conversion of sputum on the regimen, and 3 relapses. The results for the RHZS group were similar, with 4 failures to complete the regimen, 2 treatment failures and 4 relapses. Evaluation of RHZ showed it to be comparable with a previously evaluated, successful short-course regimen (RHZS). The high incidence of non-compliance probably reflects reduced supervision of this wholly oral regimen.
AuthorsR L Cowie, B A Brink
JournalSouth African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde (S Afr Med J) Vol. 77 Issue 8 Pg. 390-1 (Apr 21 1990) ISSN: 0256-9574 [Print] South Africa
PMID2184527 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References
  • Antitubercular Agents
  • Drug Combinations
  • Tablets
  • isoniazid, pyrazinamide, rifampin drug combination
  • Pyrazinamide
  • Isoniazid
  • Rifampin
  • Streptomycin
Topics
  • Adult
  • Antitubercular Agents (administration & dosage)
  • Drug Combinations
  • Drug Therapy, Combination
  • Humans
  • Isoniazid (administration & dosage, therapeutic use)
  • Male
  • Middle Aged
  • Pyrazinamide (administration & dosage, therapeutic use)
  • Randomized Controlled Trials as Topic
  • Rifampin (administration & dosage, therapeutic use)
  • Streptomycin (administration & dosage)
  • Tablets
  • Tuberculosis, Pulmonary (drug therapy)

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