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A controlled trial of a 4-weekly supplement of rifampicin, pyrazinamide and streptomycin in the continuation phase of a 7-month daily chemotherapy regimen for pulmonary tuberculosis. Tanzania/British Medical Research Council Collaborative Investigation.
S Afr Med J 1996; 86(8):960-5SA

Abstract

OBJECTIVE

To evaluate a monthly 'pulse' of rifampicin plus pyrazinamide plus streptomycin in the continuation phase of a short-course antituberculosis regimen.

DESIGN

Randomised controlled trial of two 7-month chemotherapy regimens.

SETTING

Inpatient chemotherapy and outpatient follow-up in Tanzania.

PATIENTS

Smear-positive pulmonary tuberculosis.

INTERVENTION

All patients received streptomycin plus rifampicin plus isoniazid plus pyrazinamide daily for 6 weeks followed by isoniazid daily for 24 weeks; 50%, at random, received additional doses of rifampicin, pyrazinamide and streptomycin every 4 weeks in the continuation phase. Follow-up continued for 23 months after cessation of chemotherapy.

MAIN OUTCOME MEASURES

Bacteriological failure rate at the end of chemotherapy and relapse rate after stopping.

RESULTS

Of the 266 patients with fully sensitive strains before treatment there was one failure in each series during chemotherapy; after stopping, 5% of the 114 who received the supplement relapsed bacteriologically compared with 10% of the 113 who did not (95% CI for the difference -0.02% to + 11.3%). The results in the 37 patients with strains resistant to isoniazid pretreatment were not as good, but similar for the two regimens.

CONCLUSION

This study was not large enough to demonstrate a significant reduction in the relapse rate from 10% to 5%. If such a reduction were confirmed in a larger study it would represent an important improvement in efficacy. further, in an outpatient setting, the additional monthly doses might improve attendance.

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

8823423

Citation

"A Controlled Trial of a 4-weekly Supplement of Rifampicin, Pyrazinamide and Streptomycin in the Continuation Phase of a 7-month Daily Chemotherapy Regimen for Pulmonary Tuberculosis. Tanzania/British Medical Research Council Collaborative Investigation." South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde, vol. 86, no. 8, 1996, pp. 960-5.
A controlled trial of a 4-weekly supplement of rifampicin, pyrazinamide and streptomycin in the continuation phase of a 7-month daily chemotherapy regimen for pulmonary tuberculosis. Tanzania/British Medical Research Council Collaborative Investigation. S Afr Med J. 1996;86(8):960-5.
(1996). A controlled trial of a 4-weekly supplement of rifampicin, pyrazinamide and streptomycin in the continuation phase of a 7-month daily chemotherapy regimen for pulmonary tuberculosis. Tanzania/British Medical Research Council Collaborative Investigation. South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde, 86(8), pp. 960-5.
A Controlled Trial of a 4-weekly Supplement of Rifampicin, Pyrazinamide and Streptomycin in the Continuation Phase of a 7-month Daily Chemotherapy Regimen for Pulmonary Tuberculosis. Tanzania/British Medical Research Council Collaborative Investigation. S Afr Med J. 1996;86(8):960-5. PubMed PMID: 8823423.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A controlled trial of a 4-weekly supplement of rifampicin, pyrazinamide and streptomycin in the continuation phase of a 7-month daily chemotherapy regimen for pulmonary tuberculosis. Tanzania/British Medical Research Council Collaborative Investigation. PY - 1996/8/1/pubmed PY - 1996/8/1/medline PY - 1996/8/1/entrez SP - 960 EP - 5 JF - South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde JO - S. Afr. Med. J. VL - 86 IS - 8 N2 - OBJECTIVE: To evaluate a monthly 'pulse' of rifampicin plus pyrazinamide plus streptomycin in the continuation phase of a short-course antituberculosis regimen. DESIGN: Randomised controlled trial of two 7-month chemotherapy regimens. SETTING: Inpatient chemotherapy and outpatient follow-up in Tanzania. PATIENTS: Smear-positive pulmonary tuberculosis. INTERVENTION: All patients received streptomycin plus rifampicin plus isoniazid plus pyrazinamide daily for 6 weeks followed by isoniazid daily for 24 weeks; 50%, at random, received additional doses of rifampicin, pyrazinamide and streptomycin every 4 weeks in the continuation phase. Follow-up continued for 23 months after cessation of chemotherapy. MAIN OUTCOME MEASURES: Bacteriological failure rate at the end of chemotherapy and relapse rate after stopping. RESULTS: Of the 266 patients with fully sensitive strains before treatment there was one failure in each series during chemotherapy; after stopping, 5% of the 114 who received the supplement relapsed bacteriologically compared with 10% of the 113 who did not (95% CI for the difference -0.02% to + 11.3%). The results in the 37 patients with strains resistant to isoniazid pretreatment were not as good, but similar for the two regimens. CONCLUSION: This study was not large enough to demonstrate a significant reduction in the relapse rate from 10% to 5%. If such a reduction were confirmed in a larger study it would represent an important improvement in efficacy. further, in an outpatient setting, the additional monthly doses might improve attendance. SN - 0256-9574 UR - https://www.unboundmedicine.com/medline/citation/8823423/A_controlled_trial_of_a_4_weekly_supplement_of_rifampicin_pyrazinamide_and_streptomycin_in_the_continuation_phase_of_a_7_month_daily_chemotherapy_regimen_for_pulmonary_tuberculosis__Tanzania/British_Medical_Research_Council_Collaborative_Investigation_ L2 - http://www.diseaseinfosearch.org/result/7252 DB - PRIME DP - Unbound Medicine ER -