Chemotherapy of Pulmonary Tuberculosis

SUMMARY

Effective chemotherapy has brought tuberculosis into the realm of diseases treated by general physicians in general hospitals. The primary drugs—isoniazid, para-amino-salicylic acid and streptomycin plus, in certain instances, ethambutol and pyrazinamide—are highly successful in treating patients with newly diagnosed tuberculosis. Two drug regimens containing isoniazid plus a companion drug are adequate for minimal or moderately advanced disease. Far-advanced disease is more effectively treated using three drugs including streptomycin or using the alternating regimen. Treatment of patients harboring organisms resistant to primary drugs is more difficult because of the low potency and increased toxicity of the secondary drugs. Secondary drug regimens should include at least three agents to which the organism is susceptible. Medication should not be discontinued because of vague complaints. Any suspected drug reaction must be carefully evaluated and documented.