Tubercu1osis Chemotherapy with Hydrazine Derivatives of Isonicotinic Acid

¹ The Medical Service of Sea View Hospital, Staten Island, New York.

1) Ninety-two patients with moderately or far-advanced pulmonary tuberculosis classified largely as progressive and caseouspneumonic, have been treated with the hydrazide of isonicotinic acid (Rimifon) and its isopropyl derivative (Marsilid).

2) All patients had positive sputum and active disease before institution of therapy. Forty-five were toxic and febrile.

3) Patients, divided into groups, were treated with 2, 4, and 10 milligrams per Kilo of Marsilid and 4 mg. of Rimifon for from four to 15 weeks.

4) Complete elimination of fever and toxicity occurred within two to three weeks in all cases. Appetite increase and restored sense of well-being were matched and overshadowed by weight gains which varied up to 64 pounds and averaged 18 pounds at an average of nine weeks of treatment.

5) Sputum negativity was obtained in 25 per cent of patients in from four to 15 weeks of treatment and in another 28 per cent, sharp reductions from consistent plain smear positivity to "occasionally positive" occurred.

6) Cough and expectoration were completely eliminated, or almost so, in from two to three weeks.

7) Among the 92 cases, in from four to 15 weeks, cavity closure occurred in two cases, marked reduction in cavity size was noted in 33 cases, clearing of exudate occurred 17 times.

8) Marked simultaneous diminution in several cavities within the same lung was seen three times.

9) Extension of exudate occurred four times and was minimal. One equivical new cavity appeared at the site of a pre-therapy exudate.

10) There was no death due to progression of tuberculosis.

11) Cure or marked improvement has been seen in cases of tuberculous laryngitis, tuberculous otitis, tuberculous glossitis.

12) Toxic effects of Marsilid and Rimifon therapy include hyperreflexia, leg-twitching, constipation, vertigo and reflex disturbance of micturition.

13) No death due to therapy has occurred.

14) Every patient has been benefited by therapy.

15) Clinical investigation of these previously untried new compounds, the hydrazide of isonicotinic acid (Rimifon) and its isopropyl derivative (Marsilid) reveals that they are potent agents for the treatment of human tuberculosis.