4-MONTH, 5-MONTH AND 6-MONTH REGIMENS CONTAINING ISONIAZID, RIFAMPICIN, PYRAZINAMIDE AND STREPTOMYCIN FOR TREATMENT OF PULMONARY TUBERCULOSIS UNDER PROGRAM CONDITIONS IN HONG-KONG

Setting: Ten full time urban government chest clinics in Hong Kong. Ob jective: To assess the effectiveness of 4-, 5- and 6-month fully super vised thrice-weekly regimens containing 4 months of isoniazid, rifampi cin, pyrazinamide and streptomycin followed by nil, 1 or 2 months of i soniazid and rifampicin for the treatment of smear-negative culture-ne gative, smear-negative culture-positive and smear-positive pulmonary t uberculosis. Design: Retrospective study of the 3 antituberculosis tre atment regimens given under program conditions during a 6-month period in 1983. Results: Of the 1616 patients assessed, 953 (59%) completed their treatment strictly as planned, 443 (27%) had their treatment pro longed, 107 (7%) had their treatment modified and 113 (7%) defaulted o r did not complete their treatment as planned. There were 2 treatment failures at the end of chemotherapy. At 60 months of follow-up, 67 pat ients died, 2 from the sequelae of tuberculosis. Of 1287 patients asse ssable up to 60 months, a total of 47 (3.7%) patients relapsed and wer e eventually treated successfully. 11 (20%) relapses occurred among th e 55 patients who had defaulted and did not complete treatment as plan ned.Conclusion: The effectiveness of the 3 treatment regimens depended very much on the patient's adherence to treatment. The necessity of p rolongation of treatment is not known and requires further assessment.