4-, 5- and 6-month regimens containing isoniazid, rifampicin, pyrazinamide and streptomycin for treatment of pulmonary tuberculosis under program conditions in Hong Kong.

SETTING

Ten full time urban government chest clinics in Hong Kong.

OBJECTIVE

To assess the effectiveness of 4-, 5- and 6-month fully supervised thrice-weekly regimens containing 4 months of isoniazid, rifampicin, pyrazinamide and streptomycin followed by nil, 1 or 2 months of isoniazid and rifampicin for the treatment of smear-negative culture-negative, smear-negative culture-positive and smear-positive pulmonary tuberculosis.

DESIGN

Retrospective study of the 3 antituberculosis treatment regimens given under program conditions during a 6-month period in 1983.

RESULTS

Of the 1616 patients assessed, 953 (59%) completed their treatment strictly as planned, 443 (27%) had their treatment prolonged, 107 (7%) had their treatment modified and 113 (7%) defaulted or did not complete their treatment as planned. There were 2 treatment failures at the end of chemotherapy. At 60 months of follow-up, 67 patients died, 2 from the sequelae of tuberculosis. Of 1287 patients assessable up to 60 months, a total of 47 (3.7%) patients relapsed and were eventually treated successfully. 11 (20%) relapses occurred among the 55 patients who had defaulted and did not complete treatment as planned.

CONCLUSION

The effectiveness of the 3 treatment regimens depended very much on the patient's adherence to treatment. The necessity of prolongation of treatment is not known and requires further assessment.