Streptomycin as an Adjunct to the Therapy of Pulmonary Tuberculosis

A Long Term Study

¹ The Division of Tuberculosis, Howard University Medical School and the Chronic Pulmonary Disease Service, Freedmen's Hospital.

1) Streptomycin when administered with pneumothorax to a group of 13 patients with acute exudative and pneumonic tuberculosis caused a decrease in complications, accelerated improvement, and better end results than expected from pneumothorax alone. Three died of progressive tuberculosis in whom an effective pneumothorax could not be obtained.

2) In a group of 17 patients for whom surgery was contra-indicated because of fever, type and extent of disease or contralateral disease, 16 improved to the point where surgery became feasible following streptomycin administration. Twelve of these had surgery begun and 10 had surgery completed.

3) Within two and one-half years after streptomycin was administered to the first of 16 patients for whom no collapse therapy was possible, 13 had died and one remained frankly active, unimproved. Two of these patients reached a status of apparently arrested or better.

4) The optimum time for the administration of streptomycin in conjunction with pneumothorax would appear to be prior to or in conjunction with the initiation of pneumothorax.

5) In preparing patients for major chest surgery, the optimum time is at the point of maximum improvement or as soon as surgery becomes feasible. This is because of the possibility of subsequent progression of disease with or without streptomycin.