Use of Para-Aminosalicylic Acid in Chronic Pulmonary Tuberculosis

¹ The Department of Medcine, College of Physicians and Surgeons, Columbia University and the Presbyterian Hospital, New York.

The serum of patients and normal individuals after ingestion of 2 to 4 gms. of para-aminosalicylic acid produces a definite inhibition of the growth of the tubercle bacillus in Dubos media. This has been demonstrated with the H37Rv strain as well as with strains recovered from patients with active pulmonary tuberculosis.

Para-aminosalicylic acid was administered to twelve patients with advanced chronic pulmonary tuberculosis. The dosage employed was 10 to 11 gms. daily in courses of three weeks, with a free interval of one week. In seven patients in whom the symptoms of active infection were sufficiently marked to permit judgment of the effectiveness of drug, observable clinical improvement took place in all. In three patients recurrence of symptoms on cessation of treatment took place. Three patients who suffered from fever and signs of acute exudative tuberculosis were much improved and in good general condition after treatment, but without arrest of their disease.

The characteristic effects of administration of para-aminosalicylic acid were prompt reduction in cough and expectoration, and decrease in fever when present. These favorable results were generally manifested within the first week of treatment. The side effects of the drug were intermittent nausea, vomiting and looseness of the bowels. In three of the twelve patients these symptoms were sufficiently severe to force discontinuance of the drug.

The favorable clinical results of treatment with para-aminosalicylic acid in chronic pulmonary tuberculosis suggests that this drug is a useful agent in the treatment of acute exacerbation of the disease.

The possibility that administration of para-aminosalicylic acid with other antibiotics, such as promizole and streptomycin, would appear to deserve investigation.