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Treatment of pulmonary tuberculosis in patients notified in England and Wales in 1978-9: chemotherapy and hospital admission. Medical Research Council Tuberculosis and Chest Diseases Unit.

Abstract

The treatment of adult patients, both white and of Indian, Pakistani, or Bangladeshi ethnic origin, with previously untreated pulmonary tuberculosis who were notified in England and Wales from 1 October 1978 to 31 March 1979 has been surveyed. Chemotherapy was completed as planned by the physician in charge in 820 (65%) of the 1253 patients. Eleven per cent of patients died before chemotherapy could be completed, 8% defaulted, and 6% had chemotherapy modified because of drug toxicity, and for 8% there were miscellaneous reasons for failure to complete chemotherapy. Of the 1003 patients who completed chemotherapy, 804 (80%) were prescribed isoniazid and rifampicin throughout, 667 (67%) receiving ethambutol in addition, either in the initial phase (550) or throughout chemotherapy (117). A further 129 (13%) had a regimen based on isoniazid and ethambutol throughout, and the remaining 70 had miscellaneous combinations of drugs. For the 544 patients who received a two phase regimen of isoniazid and rifampicin throughout with one or two additional drugs initially and who completed chemotherapy as planned, the median duration of chemotherapy was 10.8 months, 122 (22%) patients being treated for more than 12 months. For all 1001 patients who completed chemotherapy (whether or not as planned) and for whom the duration was known, the median duration was 11.8 months and 311 (31%) had more than 12 months' treatment. The great majority (79%) of the patients were admitted to hospital initially, the commonest reason being for investigation and diagnosis.

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