The outcomes of 20
anthracite miners with
coal workers' pneumoconiosis and culture-proved
pulmonary tuberculosis treated with
rifampin-containing chemotherapeutic regimens were determined by a retrospective review. Their mean age was 65 yr, and the duration of underground dust exposure averaged 27 yr. Nine miners had simple
pneumoconiosis, 11 had progressive massive
fibrosis, and 13 had cavitary disease; 3 also had extrapulmonary disease. All patients were given
rifampin (mean, 12 months in survivors) plus one or more other effective agents; the mean
duration of treatment with 2 or more drugs was 17 months. Follow-up averaged 46 months in those surviving more than 1 yr. Sputum cultures became negative and remained so within 3 months in 17 patients and within 5 months in the remainder. Eighteen patients survived more than 1 yr after completing
chemotherapy. No clinical, radiologic, or bacteriologic relapses were observed during follow-up, but 5 patients died of nontuberculous causes. These results are superior to those reported previously in patients with
coal workers' pneumoconiosis treated for
pulmonary tuberculosis with regimens not containing
rifampin. They suggest that treatment of
tuberculosis in
coal workers, even in the presence of progressive massive
fibrosis and cavitary disease, can yield results as favorable as in nonpneumoconiotic patients provided the initial treatment regimen includes
rifampin plus one or more other effective agents.