Experiences in the Management of Long-Standing Chronic Cases of Pulmonary Tuberculosis Treated with Isoniazid for One Year

¹ Dunham Hospital of Hamilton County (Tuberculosis), (a Subdepartment in the Department of Medicine, College of Medicine, University of Cincinnati)

1. Thirty-eight "maximum benefit" or "good chronic" cases of pulmonary tuberculosis considered therapeutic failures to streptomycin and para-aminosalicylic acid, when treated with isoniazid alone for one year showed a promising clinical response.

2. Marked improvement in subjective symptoms such as morale and sense of well-being were noted from the onset of therapy. Improvement of appetite and weight gain were marked. Cough reduction and sputum volume reduction were striking. A sharp reduction in consumption of cough medicine paralleled the finding of cough and sputum reduction.

3. X-ray shadow improvement did not parallel clinical bettering. However, definite roentgenologic improvement was demonstrable, and after one year, six patients, heretofore considered to have poor prognosis for cure, were discharged from the hospital as arrested, with negative sputum.

4. An appreciable reduction in positive sputa was observed soon after institution of therapy. After one month of therapy the number with positive sputum decreased from 36 to nine. At any given time during the study the incidence of positive sputa among these patients was less than 50 per cent, whereas prior to therapy over 94 per cent were positive.

5. Isoniazid alone may have therapeutic efficacy in the management of "maximum benefit" or "good chronic" cases upon whom other therapeutic regimens have failed.