A controlled comparison of two fully supervised once-weekly regimerns in the treatment of newly diagnosed pulmonary tuberculosis

controlled study of a year’s treatment, on an out-patient basis, with one of the following two fully supervised regimens : SH/SH0W. Streptomycin 1 g or 0.75 g plus isoniazid 400 mg administered daily for the first four weeks, followed by streptomycin in the same dosage plus isoniazid 13 mg/kg or 17 mg/kg body-weight, administered once a week for the rest of the year. Pyridoxine 6 mg was incorporated in every dose of isoniazid. SPH/SPHOW. Streptomycin, isoniazid and pyridoxine in the same dosages as in the SH/SHOW regimen, plus sodium PAS 6 g throughout the year, all the drugs being administered daily for the first four weeks and once a week for the rest of the year. The regimen, the streptomycin dosage and the once-weekly isoniazid dosage were allocated at random for each patient. The main analyses in this report concern 359 newly-diagnosed patients (181 SH/SHOW, 178 SPH/SPHOW) with cultures sensitive to isoniazid and streptomycin on admission. About 90 per cent of the patients had cavitated disease and a positive sputum smear on admission, and 40 per cent were rapid inactivators of isoniazid. The condition on admission was similar for the two series. Two patients (both SH/SHOW) died of tuberculosis and four (all SH/SHOW) had their chemotherapy changed on account of radiographic or clinical deterioration in the presence of a positive sputum. At one year, 85 per cent of the SH/SHOW and 87 per cent of the SPH/SPHOW patients were classified as having a favourable response, mainly on the basis of culture results at 10, 11 and 12 months. Among those who had an unfavourable response, approximately half had responded well initially but had a bacteriological relapse by one year. Considerable or exceptional radiographic improvement was shown by about three-fourths of the patients in each series, and cavitation had disappeared in about half