Further Experiences with the Clinical Use of Streptomycylidene Isonicotinyl Hydrazine Sulfate in the Therapy of Pulmonary Tuberculosis

Streptomycylidene isonicotinyl hydrazine sulfate, 1.4 grams intramuscularly when given daily for 10 days and then twice weekly to original treatment patients gives bacteriologic and roentgenographic improvement comparable to that observed for proved regimens over an observation period of 12 months.

X-ray improvement is somewhat slower for streptomycylidene isonicotinyl hydrazine sulfate intermittently treated patients.

This regimen is less effective for patients having had prior therapy with isoniazid or streptomycin or both.

Patients who have had consistent isoniazid resistant cultures prior to streptomycylidene isonicotinyl hydrazine sulfate therapy are not especially benefited by streptomycylidene isonicotinyl hydrazine sulfate.

Bacterial resistance to concentrations of 1 mcg. or more of isoniazid develops more frequently among intermittently treated prior-therapy patients but on no regimen was drug resistance considered a significant factor.

Intermittent streptomycylidene isonicotinyl hydrazine sulfate, bi-weekly, may safely be used as a maintenance routine after maximal x-ray and bacteriologic improvement occur. It should only be used per primum for patients with a good prognosis who can be expected not to require prolonged periods of drug therapy to bring about retrogression of disease.

It is desirable to try daily streptomycylidene isonicotinyl hydrazine sulfate for 30 to 60 days in comparison to daily isoniazid regimens since daily streptomycin has not rigorously been tested in this fashion.