SHORT-COURSE CHEMOTHERAPY FOR TUBERCULOSIS WITH LARGELY TWICE-WEEKLY ISONIAZID-RIFAMPIN

Although short-course, largely twice weekly chemotherapy for treatment of tuberculosis was shown to be effective in other countries, when given under closely controlled conditions, it was not adopted in the USA where most patients are older and are treated as outpatients. Since Jan., 1976, 315 patients (mean age 55.5 yr) with proven pulmonary tuberculosis were treated with rifampin (RIF) 600 mg and isoniazid (INH) 300 mg daily for 1 mo., followed by RIF 600 mg and INH 900 mg twice-weekly for another 8 mo., self-administered except for a few patients. By 3 mo., 95% converted to negative culture. There were only 10 failures among 185 patients in whom final results could be assessed. There has been only 1 relapse during 1-21 mo. of follow-up in 175 patients. Serious side effects were few: 6 instances of jaundice, 2 of "flu-like syndrome" and 1 of thrombocytopenia. This form of initial therapy for tuberculosis is safe, effective and economical.