CLINICAL SIGNIFICANCE OF LOW DEGREES OF DRUG RESISTANCE IN PULMONARY TUBERCULOSIS

Publisher Website
Google Scholar
Abstract
The significance of different degrees of bacterial drug resistance to streptomycin, para-aminosalicylic-acid (PAS) and isoniazid was determined by the analysis of deterioration under treatment of 70 patients with pul-monary tuberculosis undergoing 187 treatment courses. Most of the patients had far advanced chronic disease previously treated with unsatisfactory drug combinations. Deterioration was frequent. It occurred as often in patients with organisms of a low degree of resistance as in those with highly resistant bacilli. Seven patients with bacilli of a low degree of resistance to at least 1 of the standard drugs, and susceptible or of low degree of resistance to a second drug, were treated with the standard drugs in normally adequate combinations. In 2 of the patients the low degree of resistance was primary. Deterioration under treatment occurred in all 7 cases. The routine susceptibility test should discriminate between slightly resistant and fully susceptible organisms. It is essential that a correlation be made between the results of the susceptibility tests and the clinical and bacteriologic response of the patient to treatment with the drug given in adequate combination. Deterioration with such treatment suggests that the method being used is not always efficient in detecting resistant bacilli. The susceptibility tests carried out in Lowenstein-Jensen medium using 2-fold dilutions of the drug gives a very good correlation between clinical and bacteriologic response to treatment and the susceptibility of the patient''s organisms.

This publication has 0 references indexed in Scilit: