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Biomedical subjects

P Chaulet

Publications and source records attributed to P Chaulet.

At least 37 records · Page 2Linked to original sources
PubMed1990

[The anti-tuberculosis campaign throughout the world: strategies and actions in the field].

Tuberculosis will remain one of the main health concerns in the world for the next ten years. Economic crises in the Third World and AIDS epidemics in Africa have contributed to maintain a high level prevalence of tuberculosis in the poorest countries. Failures of tuberculosis control measures are due more often to mistakes in health planning and in health manpower training than to the lack of technologies. Short-course chemotherapy is an important technological achievement for the treatment of tuberculosis, but case holding and case finding are not efficient in several high-prevalence countries. BCG vaccination and chemoprophylaxis, especially in immunodeficient children or adults, need more evaluation studies.

Adult↗
PubMed1990

[A therapeutic trial of a combination of 3 essential drugs in a short course of chemotherapy in tuberculosis. Results 6 months after the end of treatment].

250 patients suffering from pulmonary tuberculosis who were smear positive received a chemotherapy regime for 6 months combining Rifampicin and Isoniazid every day with a daily supplement of Pyrazinamide for the first 8 weeks. The three drugs given in the initial phase of treatment were administered either separately or in combined preparations according to the 2 controlled randomised groups. During the maintenance phase the drugs were given in a combined form in fixed proportions in the 2 groups. 6 months after the end of treatment the bacteriological results were similar in the 2 groups in the 144 cases which were analysed. Amongst 137 cases with bacilli which were initially sensitive to Isoniazid (68 cases with separate medicines at the beginning and 69 with combined drugs) there was no failure at 6 months, nor any relapse during the course of the first period of surveillance. Amongst 7 cases with bacilli which were originally resistant to Isoniazid (4 and 3 respectively), there were 2 failures at 6 months one in each group with acquired resistance to Rifampicin observed at the time of the failure. There was no difference in the therapeutic results observed whatever the presentation of drugs used during the initial phase of treatment.

Drug Combinations↗
PubMed1989

[Therapeutic trial of a combination of isoniazid, rifampicin and pyrazinamide in the first 2 months of treatment of pulmonary tuberculosis].

250 patients suffering from smear positive pulmonary tuberculosis who had never been treated before, received a six-month regimen combining isoniazid and rifampicin every day with a supplement of pyrazinamide for the first eight weeks of treatment. The three drugs given during the initial phase of therapy were administered in two different forms: either as separate tablets or in a form combining all three drugs in fixed proportions (each tablet contained 50 mg of isoniazid, 120 mg of rifampicin and 300 mg of pyrazinamide). The patients were randomised into two groups of 125 receiving one or other combination of medications with the dose adapted for their weight. An analysis of the results at the end of the second month of treatment was carried out on 240 cases who could be analysed for tolerance and acceptability and in 193 cases who were analysed for the efficacy of therapy as judged by negative cultures. The treatment results were excellent in both groups, as was patient acceptability. The level of side effects was significantly lower in the group receiving combined medication (p less than 0.02). Both groups gave a similar proportion of negative cultures at the end of two months. The combined medicaments studied are thus well tolerated and at least as effective as individual drugs. They may thus replace them.

Adolescent↗
PubMed1989

Tuberculosis: a six-month cure.

Today the treatment of tuberculosis can be based on a course of chemotherapy that lasts only 6 months, giving patients the best change of cure and affording the health personnel an exceptional opportunity to improve both their patients' compliance with the treatment and the overall efficiency of their own activities.

Antitubercular Agents↗
PubMed1986

[Results of a therapeutic trial comparing a 6-month regimen to a 12-month regimen in the treatment of pulmonary tuberculosis in the Algerian Sahara. Final report: results 3 years after the onset of treatment].

This study has compared a daily 6-month short-course chemotherapy regimen and a daily 12-month standard duration regimen in the treatment of smear positive pulmonary tuberculosis in a rural area of Algeria where the population contains a relatively high proportion of nomads. The 6-month regimen (6M) was isoniazid and rifampicin throughout with ethambutol and pyrazinamide in addition for the first 2 months, and the 12-month regimen (12M) was isoniazid and ethambutol supplemented by streptomycin during the first month. All the 601 patients admitted had one or more sputum smears positive on examination in the local laboratory and 70% had a positive culture in the reference laboratory in Algiers. Most patients were admitted to hospital initially for one or two months where chemotherapy was fully supervised and subsequently it was self-administered. In both nomads and settled residents known to have fully sensitive strains of tubercle bacilli pretreatment the 6-month regimen was highly effective with no failures during chemotherapy and only 3% relapses after stopping chemotherapy in 126 patients compared with a combined failure rate during chemotherapy and relapse rate of 21% in the 152 patients receiving the 12-month regimen (P less than 0.001). The results in patients with isoniazid-resistant strains pretreatment were also significantly better for the 6-month than for the 12-month regimen, one of 15 and 8 of 17 patients respectively being classified as failures or relapses (P = 0.03). To assess the results which might be achieved by these regimens under programme conditions the outcome at 3 years was also assessed in all patients admitted to the study irrespective of whether the disease was confirmed in the reference laboratory or at independent assessment and whether or not the allocated chemotherapy was modified or further courses of chemotherapy were given. At 3 years, 82% of the 6M and 80% of the 299 12M patients had achieved a favourable status and only one 6M patient and 4 12M patients were still known to have active disease with a positive culture. A further 23 6M and 22 12M patients were known to have died, 11 in each series probably or definitely from tuberculosis. The remaining 28 6M and 34 12M patients were lost from follow-up, but 24 and 22 respectively had completed their allocated chemotherapy before defaulting. It was estimated that, overall, 272 (94%) of the 6M and 263 (91%) of the 12M patients had a favourable status at 3 years.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1985

[Controlled study comparing 3 daily chemotherapy regimens for six months in pulmonary tuberculosis in routine practice in Algiers. Results at 30 months].

Three anti-tuberculous regimens were compared in Algiers. The three regimens use Isoniazid and Rifampicin every day for six months; two of them used a third drug, Ethambutol or Pyrazinamide for the first three months. The results at 12 months after cessation of chemotherapy have already been reported. At 30 months (or 24 months after the end of treatment) the results were analysed for 513 cases: in 27 cases (5%) there was a relapse or therapy failed. Of 21 relapses 13 occurred in the first six months of follow up, four during the next six months, three during the third and one in the final six months. No further relapse was seen between the thirtieth and forty second months. All the cases of failure or relapse had received an additive chemotherapy. Two patients were on chemotherapy again for a relapse noted in under six months; the other 25 patients had a satisfactory outcome after receiving a regime of six to 12 months containing Rifampicin in 21 cases or a regime 12 months without Rifampicin in four cases. There was no statistically significant difference between the three therapeutic series for those cases with tubercle bacilli initially sensitive to the antituberculous drugs. On the other hand, for primary Isoniazid resistance a third drug is essential during the initial treatment. In the overall analysis pyrazinamide was as effective as Ethambutol in avoiding failure due to primary drug resistance and relapses up to 30 months.

Antitubercular Agents↗
PubMed1983

[Problems of tuberculosis in the world today].

A century after Robert Koch's discovery of the tubercle bacillus the world total of tuberculosis sufferers is estimated at 20 million, 10 million of whom are contagious. Contrary to a widespread opinion, tuberculosis has not regressed over the last 30 years because it chiefly affects the Third World, in which countries the population doubles every 20 or 25 years while economic resources remain static for the majority of the population. Tuberculosis will be a serious problem of world health in the year 2000. These facts should stimulate physicians to exploit the technical possibilities to the full, with stress upon detection and chemotherapy of tuberculosis. A health program will need to be established for these nations which will make it possible to identify and treat the maximum number of sources of infection. All the investigations and efforts at international cooperation in the field of tuberculosis should be directed towards improving or intensifying national antituberculosis programs.

Antitubercular Agents↗
PubMed1983

[Comparison of 3 6-month chemotherapy regimes in pulmonary tuberculosis in routine practice in Algiers. 18th-month results].

Three 6 month antituberculous regimes were compared during a controlled trial in Algiers. Isoniazid and Rifampicin were used every day for six months in all three regimes; a third drug was used as a supplement in two of the three regimes during the first three months (Ethambutol or Pyrazinamide). The aim of the study was to assess the role of the third drug and also the suitability of a self-administered regime in routine practice. The results were analysed at eighteen months, twelve months after the end of therapy. The third drug had no influence on outcome in patients with sensitive organisms. There was a 2.5% relapse rate with no significant difference between the groups. On the other hand the third drug was crucial for those patients initially resistant to Isoniazid, because a relapse or failure due to primary resistance was avoided. The 6 month regimes were well tolerated: the treatment was only changed in 0.8% of cases for major toxicity. Finally, short self-administered oral regimens were well tolerated by the patients.

Adolescent↗