Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PYRAZINAMIDE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,261 records · Page 70Linked to original sources
PubMed1979

Sputum-smear-negative pulmonary tuberculosis: controlled trial of 3-month and 2-month regimens of chemotherapy.

Of 1072 Chinese patients with radiographically active pulmonary tuberculosis and no microscopic evidence of acid-fast bacilli in sputum examinations, only 691 (64%) were sputum-culture negative. All patients were randomly allocated to selective chemotherapy (antituberculosis chemotherapy not being started until the activity of the disease had been confirmed), to daily streptomycin, isoniazid, rifampicin, and pyrazinamide for 2 months or 3 months, or to a standard 12-month control regimen. During the subsequent 12 months, 64% of the patients in the selective chemotherapy series started antituberculosis chemotherapy. Both 2-month and 3-month regimens were inadequate for patients whose pretreatment sputum cultures were positive (relapse-rates 14% and 7%, respectively, in patients with drug-sensitive strains) but in the patients whose first cultures were negative the relapse-rate was only 1% after both short-term regimens.

Adolescent↗
PubMed1996

The duration of excretion of viable bacilli in elderly patients on treatment for cavitating pulmonary tuberculosis.

OBJECTIVE: To determine the period of excretion of viable tubercle bacilli in cavitating pulmonary tuberculosis in elderly patients while on treatment. DESIGN: 10 consecutive black hospital inpatients over the age of 65 years (6 men, 4 women) with positive acid-fast bacilli smears and Lowenstein-Jenssen culture-proven pulmonary tuberculosis and radiological cavitation had weekly smears and cultures until at least three smears or two cultures were negative. INTERVENTION: Supervised treatment comprising rifampicin, pyrazinamide, ethambutol and isoniazid. RESULTS: It look an average of 5.7 weeks (range 4-9 weeks) for the cultures and 8.2 weeks (range 4-14 weeks) for the smears to become negative. CONCLUSION: Patients with cavitating pulmonary tuberculosis continue to excrete viable tubercle bacilli for approximately 6 weeks despite supervised treatment. It is suggested that allowing such patients back into an environment where three are immunocompromised subjects (e.g. elderly people in retirement homes or HIV-positive subjects) is probably hazardous until the patients are culture or smear negative.

Aged↗
PubMed1996

Oral tuberculosis following autologous bone marrow transplantation for Hodgkin's disease with interleukin-2 and alpha-interferon immunotherapy.

A patient with Hodgkin's disease (HD) underwent autologous bone marrow transplantation (ABMT). Six months later while receiving interleukin (IL)-2 and alpha-interferon immunotherapy, he developed a painful lesion in his oral cavity with a fistula in the buccal area. Excision biopsy disclosed necrotizing granulomatous inflammation with acid-fast bacillus. The patient received a 9-month course of isoniazide, rifampin and pyrazinamide, and recovered. The possible pathophysiological mechanism is discussed.

Adjuvants, Immunologic↗
PubMed1977

Renal urate excretion in five cases of hypouricemia with an isolated renal defect of urate transport.

Renal urate excretion was studied in two familial, one suspected familial, and two isolated cases of hypouricemia due to a renal defect. All had very low plasma urate concentrations. In four cases, the urate clearances were approximately the same as the creatinine clearances, and in one case reduced to about one-third. In all cases the urate clearances were minimally diminished by both pyrazinamide and probenecid. This renal response to the drugs is probably due to and isolated tubular defect in the reabsorptive transport mechanism of urate. Following intravenous administration of uric acid, one patient excreted uric acid in the urine more rapidly than a normal subject. In this patient, uric acid secretion from renal tubules was clearly demonstrated during infusion of uric acid. In de novo synthesis of purine, no definite abnormalities were found by incorporation of glycine-15N to uric acid.

Adult↗
PubMed1996

[Severe hepatotoxicity of tuberculostatic agents. Increase in the incidence].

Hepatotoxicity by antituberculous drugs is well known. Nonetheless, severe liver involvement is infrequent. Several series of fulminant hepatitis by antituberculous drugs have recently been reported with a much greater frequency than previously reported. The present study describes the authors' experience which, similar to other groups, has shown a marked increase with respect to previous experience. During 1994 5 patients with acute severe hepatitis associated to antituberculous drugs were admitted to the authors' unit. The mean age of the patients was 43 years (range: 25-62). Two patients were healthy HBsAg carriers, one undergoing enzymatic inducer treatment and was anti-HIV positive. Another patient presented compensated liver cirrhosis by HCV. The 5 cases received combined isoniazid and rifampicin and four had also received pyrazinamide. Four patients presented hepatic encephalopathy. Of these cases, three could not undergo emergency liver transplantation because of contraindications and died due to complications of acute severe liver failure. Another patient evolved favorably following emergency liver transplantation. The only patient who presented good evolution with conservative treatment and who did not present hepatic encephalopathy had discontinued isoniazid because of the finding of slight hypertransaminasemia during a routine analytical control. Several risk factors have been reported for the appearance of hepatotoxicity by antituberculous drugs. The factor of greatest clinical importance for the development of severe hepatotoxicity is probably continuation of the treatment once hepatic dysfunction has initiated. The important increase in cases of severe toxicity urges the need for strict analytical monitoring following initiation of treatment.

Acute Disease↗
PubMed1997

Randomised controlled clinical trial of short course chemotherapy in abdominal tuberculosis: a five-year report.

OBJECTIVES: To assess and compare the efficacy of a 6-month short-course chemotherapy regimen (SCC) with that of a 12-month standard regimen in the treatment of abdominal tuberculosis. DESIGN AND SUBJECTS: A total of 193 adult patients with evidence of abdominal tuberculosis were randomly allocated to one of two daily regimens: 1) a 6-month SCC regimen with rifampicin, isoniazid and pyrazinamide for 2 months followed by rifampicin with isoniazid for another 4 months (6R series) and 2) and 12-month standard regimen of ethambutol and isoniazid with streptomycin supplemented for 2 weeks (12E series). Surgery was undertaken only for patients suspected to have obstruction or perforation of the intestine. RESULTS: A total of 163 (85 6R, 78 12E) patients were available for efficacy analysis after exclusion of 30 patients for various reasons. At the end of treatment clinical status was normal in 84 (99%) in 6R patients and in 73 (94%) in 12E patients. Of these, 147 patients completed follow-up for 5 years; none had relapsed requiring treatment for abdominal tuberculosis. CONCLUSION: A 6-month SCC regimen has been found to be as effective as the standard 12-month regimen in the treatment of all forms of abdominal tuberculosis.

Adolescent↗
PubMed1997

A controlled clinical trial of oral short-course regimens in the treatment of sputum-positive pulmonary tuberculosis. Tuberculosis Research Centre.

SETTING: The Tuberculosis Research Centre, Chennai, and its unit at Madurai, South India. OBJECTIVE: To design oral short-course regimens for the treatment of sputum-positive pulmonary tuberculosis that could be more easily implemented under field conditions. DESIGN: A total of 1203 patients was randomly allocated to one of three regimens. I (2EHRZ7/6EH7): 8-month daily regimen of ethambutol (E), isoniazid (H), rifampicin (R) and pyrazinamide (Z) for 2 months, followed by E and H for 6 months. II (2EHRZ2/4EHR2): 6-month twice-weekly regimen with the same four drugs for 2 months, followed by EHR for 4 months. III (2HRZ2/4HR2): similar to Reg. II, but without ethambutol. In Reg. I, drugs were given completely unsupervised. Regs. II and III were either completely or partially supervised. RESULTS: Drug-susceptible group: At the end of treatment, 3.6% of 305 patients in Reg. I, 0.4% of 263 in Reg. II and 9.3% of 257 in Reg. III had an unfavourable bacteriological response. By 24 months after start of treatment, 5% of 290 in Reg. I, 11% of 258 in Reg. II and 10% of 229 in Reg. III had a bacteriological relapse requiring treatment. Giving the twice-weekly regimens partly unsupervised did not influence the response to treatment, emergence of drug resistance or relapse rates. Isoniazid resistant group: Unfavourable response and relapse with Reg. I (94 patients) was 17% and 8%, with Reg. II (59 patients) 20% and 25%, and with Reg. III (74 patients) 62% and 15%, respectively. CONCLUSION: A fully unsupervised ethambutol-containing regimen given daily for 8 months (Reg. I) was found to be very effective even in the presence of isoniazid-resistant bacilli. With the ethambutol-containing twice-weekly regimen, the response at the end of treatment was near 100%, but the relapse rate was high (11%). The non-ethambutol twice-weekly regimen was not satisfactory. All three regimens failed in the presence of bacilli resistant to rifampicin and isoniazid.

Administration, Oral↗
PubMed1997

[Tuberculosis in hemodialysis].

The authors report a retrospective study in order to illustrate the particular features of tuberculosis in hemodialysis population. Thirty two patients over 203 (15.8%) in periodic hemodialysis, have presented a tuberculosis between 1983 and 1996. There were 17 men and 15 women aged from 14 to 60 years old. The features of the tuberculosis in these cases were marked by the extrapulmonary localizations (50%) notably nodes tuberculosis, and the difficulties of the diagnosis certainty. The diagnosis was suspected basing on the fever, the weigh loss, the rate sedimentation increase and the radiologic lesions in pulmonary tuberculosis and peripheric or deep lymph nodes involvement. The diagnosis confirmation was established bacteriologically in 6 cases (18.7%) and histologically in 14 cases (43.8%). The treatment consisted on the association of isoniazide, rifampicin and pyrazinamide which leads to recovery in 87.5%. This treatment was a diagnosis proof in the absence of confirmation.

Adolescent↗
PubMed1997

[Antitubercular chemotherapy].

Treatment of tuberculosis has three major goals: healing the patient, preventing selection of resistant strains and control transmission of tuberculosis. A 6 month regimen consisting of isoniazid, rifampin with addition of pyrazinamide for 2 months is the preferred treatment for pulmonary and extra-pulmonary tuberculosis. If resistance to isoniazid is suspected, ethambutol should be added until drug susceptibility studies become available. This treatment is effective in both HIV infected and uniinfected persons. Treatment failure is mostly related to lack of patient adherence to the drug regimen and to multidrug-resistant tuberculosis. The treatment of multidrug-resistant tuberculosis requires second line drugs which are less effective and poorly tolerated. Prevention of resistant tuberculosis needs adequate treatment of each case of tuberculosis and improving of the patient compliance.

AIDS-Related Opportunistic Infections↗
PubMed1998

Physician compliance with national tuberculosis treatment guidelines: a university hospital study.

SETTING: The Aga Khan University Hospital, in Karachi, Pakistan, is a 650-bed university teaching hospital. OBJECTIVES: There is little data from Pakistan on the awareness and application of the World Health Organization (WHO)'s tuberculosis treatment guidelines among physicians. This study evaluates physician compliance with these guidelines. DESIGN: A questionnaire to measure physician compliance was developed, pilot tested and standardised. Case records of all patients hospitalized with tuberculosis were reviewed (January-December 1995, n = 229), and were classified into WHO Category 1 (n = 191), Category 2 (n = 9) and Category 3 (n = 29). RESULTS: A total of 53 (23%) patients had a diagnostic bacteriological sputum smear examination, of which 38% were smear positive and 47% culture positive. Of 25 cerebrospinal fluid cultures 12% were positive. No sputum smear tests were conducted during treatment. Of 58 patients in Category 1 who completed therapy 74% received a 2-month intensive phase consisting of HRZE (isoniazid, rifampicin, pyrazinamide, ethambutol) (n = 43), while 41% received a 6 month continuation phase with HE (n = 24). Over 70% patients were lost to follow up, more than half of these during the intensive phase. CONCLUSION: Our study reflects poor awareness of the WHO guidelines and low compliance among physicians, and a high loss to follow-up. Efforts are needed to create physician awareness about the WHO guidelines and their use. This study can be used to assess the effectiveness of any future physician education and to identify areas of weakness in health care.

Antitubercular Agents↗
PubMed1998

[Complications of polychemotherapy for renal tuberculosis].

The paper analyzes the incidence of adverse reactions caused by tuberculostatics used in the treatment of renal tuberculosis by follow-ups of 117 patients. Current polychemotherapy for renal tuberculosis has been found to be complicated by drug intolerance in 40.1% of cases. Intermittent intravenous injection of tuberculostatics causes side effects in 36.8% of patients while conventional treatment does in 59.1%. Pyrazinamide, streptomycin, and ethambutol are most toxic to patients with renal tuberculosis. There is a higher likelihood of drug intolerance in females with bilateral nephrotuberculosis complicated by chronic renal failure.

Adult↗
PubMed1998

Should we take a history of prior treatment, and check sputum status at 2-3 months when treating patients for tuberculosis?

SETTING: Pinetown, South Africa (1975-1983). OBJECTIVE: To determine the value of previous treatment history and sputum smear examination at 2-3 months in predicting treatment failure and relapse in tuberculosis patients treated with four drugs given twice weekly for six months under direct observation. DESIGN: Four cohort studies among 562 ambulant adults with culture positive pulmonary tuberculosis, designed to test the effectiveness of isoniazid 600-900 mg, rifampicin 600 mg, pyrazinamide 2-3 g, and streptomycin 1-2 g, given twice weekly. The same drug regimen was given to all patients irrespective of previous treatment history. Therapy was not changed if smears remained positive at 2-3 months. RESULTS: Positive predictive values of a history of previous treatment for a positive smear at 2-3 months (18.3%), treatment failure (5.2%), and relapse (9.4%) were poor. Although patients with positive smears at 2-3 months were more likely to fail therapy than patients with negative smears (relative risk=4.5, 95% Confidence Interval [CI]: 1.6-12.8), positive predictive value for treatment failure was only 12.5%. Although relapse was more frequent in patients with positive smears than those with negative smears (9.7% vs 6.2%; P=0.4), most patients who relapsed had been smear negative at 2-3 months (18/21). CONCLUSION: A four-drug rifampicin-containing regimen can safely be given twice weekly under direct observation to both new and retreatment cases, and the 2-3 month smear examination can safely be omitted.

Adult↗
PubMed1998

Short-course chemotherapy for isoniazid-resistant pulmonary tuberculosis.

Standard short-course chemotherapy including isoniazid, rifampicin, pyrazinamide, and ethambutol has been the recommended treatment for tuberculosis in Taiwan since November 1990. The effectiveness of this treatment was evaluated retrospectively in 108 patients with isolates resistant to isoniazid alone and 115 patients with drug-susceptible pulmonary tuberculosis diagnosed and treated at the Taiwan Provincial Chronic Disease Control Bureau from November 1990 through December 1995. The success rate of treatment was 94.4% in patients with isoniazid-resistant Mycobacterium tuberculosis strains, which was not significantly different from the 97.4% rate in patients with susceptible strains. Of the patients treated successfully, no bacteriologic relapse was found in 97 patients with isoniazid-resistant strains or 103 patients with drug-susceptible strains 12 months after the end of chemotherapy. No significant advantage in treatment outcome was found in patients infected with isoniazid-resistant strains who received chemotherapy for more than 6 months (successful treatment rate, 95.0% vs 92.8%), but the failure rate was higher in patients with a previous history of antituberculosis therapy (17.6% vs 3.3%). We conclude that short-course chemotherapy is effective for isoniazid-resistant pulmonary tuberculosis and that there is no significant difference in treatment outcome between patients with or without isoniazid-resistant disease.

Antitubercular Agents↗
PubMed1998

Current HIV seroprevalence rate and incidence of adverse skin reactions in adults with pulmonary tuberculosis receiving thiacetazone-free antituberculosis treatment in Yaounde, Cameroon.

OBJECTIVES: To determine the current HIV seroprevalence in adult patients with pulmonary tuberculosis in Yaounde and to compare the incidence of adverse skin reactions in these patients with and without HIV infection receiving thiacetazone-free antituberculosis treatment. DESIGN: Case series. SETTING: Chest clinic of Hospital Jamot in Yaounde, Cameroon. SUBJECTS: 235 consecutive patients aged > or = 15 years with a diagnosis of pulmonary tuberculosis from July 1 to December 31, 1994. MAIN OUTCOME MEASURES: HIV seroprevalence and incidence of adverse skin reactions to antituberculosis treatment. RESULTS: Of the 235 patients studied, 156 (66%) were male (mean age: 33 range 17 to 84 years) and 79 were female (mean age: 30.3, range 16 to 64 years). Overall 16.6% (39 cases) of the 235 patients were HIV seropositive. The prevalence of HIV infection was significantly higher in women (24%) than in men (12.5%) (p = 0.045). Adverse skin reactions to antituberculosis treatment were observed in 11 (4.7%) of the 235 patients. The incidence of the reactions was significantly higher in HIV seropositive (23.1%) than HIV seronegative patients (1.0%) (p < 0.001). Two HIV seropositive patients who developed Steven-Jonson syndrome died. The drugs incriminated for adverse skin reactions in the nine patients who survived were pyrazinamide (four cases) and rifampicin (five cases). CONCLUSION: HIV infected patients on antituberculosis drug should be monitored for adverse skin reactions which are sometimes fatal.

AIDS-Related Opportunistic Infections↗
PubMed1998

Intensive short course chemotherapy in the management of tuberculous meningitis.

SETTING: Short course chemotherapy for tuberculous meningitis (TBM) is advocated by several groups, but relatively few children have been so treated and followed up. METHODS: A prospective, observational study of isoniazid (INH), rifampicin (RMP) and ethionamide (ETH) in a dosage of 20 mg/kg, and pyrazinamide (PZA) 40 mg/kg, all given once daily in hospital for 6 months. Surviving children were followed up for a year after discharge. RESULTS: Ninety five children, 39 (41%) at stage III, 52 (55%) at stage II and 4 (4%) at stage I TBM were studied. Ten (26%) at stage III and 3 (6%) at stage II died before completion of therapy. Five surviving children (6%) moved on discharge and were untraceable; seven children (9%) were lost during follow up and three were inadvertently restarted on antituberculosis therapy. Two children with severe stage III disease died after discharge. One child experienced a probable disease recrudescence 1 month after discharge. Eighteen children (20%) developed a mildly elevated serum bilirubin concentration during the first month of treatment. In five of these children INH, RMP, ETH and PZA were stopped and streptomycin (SM) and ethambutol substituted. In all cases the original treatment was restarted without incident. One child developed overt jaundice after 5 months of treatment due to hepatitis A infection. CONCLUSIONS: Our experience suggests that young children with TBM can be safely treated for 6 months with high doses of antituberculosis agents without overt hepatotoxicity and with a low risk of relapse.

Antibiotics, Antitubercular↗
PubMed1998

Restoration of the uricosuric effect of probenecid after triglycylvasopressine administration in a gouty patient.

A 35-year-old patient with severe gout and mild renal insufficiency presented very low urinary urate excretion. Volume expansion induced by fludrocortisone combined or not with a uricosuric drug (Benzbromarone) was unable to significantly increase his urate excretion. A combined Probenecid (PB) and Pyrazinamide (PZA) test was performed. These drugs being considered to affect renal tubular reabsorption or secretion. No significant modification of uric acid fractional excretion (FE.uric acid) was observed after PB and PZA. When the same test was performed after the administration of Triglycyl-lysine vasopressine (TGLV), a potent V1 receptor stimulator, we observed a three fold increase in FE.uric acid after PB intake (from 6 to 18%) followed by a decrease after PZA (from 18 to 5.6%). When TGLV was administered alone their was no significant modification of uric acid fractional excretion. We propose that TGLV decrease proximal tubular urate reabsorption that could only be detected when postsecretory reabsorption is blocked by an uricosuric drug.

Absorption↗
PubMed1998

[Lomefloxacin in complex treatment of acute progressive form of pulmonary tuberculosis].

The effect of lomefloxacin in combination with isoniazid, pyrazinamide, streptomycin or ethambutol on the process of tuberculosis and concomitant nonspecific pathological processes in the lungs was investigated in the treatment of 69 patients with newly diagnosticated acute progressive destructive tuberculosis of the lungs and isolation of Mycobacterium tuberculosis. It was shown that lomefloxacin provided rapid disappearance of the disease clinical signs and bacillus isolation in the patients with tuberculosis due to the tubercle bacilli susceptible or resistant to the main antituberculosis drugs, acceleration of the resolution of the infiltrates and caseous lesions in the lungs and elimination of the pathological processes in the bronchi. The tolerance of lomefloxacin was satisfactory and it did not affect the tolerance of the other antituberculosis drugs.

Acute Disease↗
PubMed1998

[Efficacy of a short 6 month therapeutic coursefor HIV infected tuberculosis patients in Abidjan, Côte d'Ivoire].

From December 1992 to February 1993, 104 newly diagnosed pulmonary tuberculosis patients were enrolled in a prospective cohort study to assess the response to the 6 month-short-course regimen implemented in Cote d'Ivoire. This treatment encompassed the daily intake of Rifampicin and Pyrazinamide for 2 months followed by Rifampicin and Isoniazid for the remaining 4 months. All the patients were enrolled at the Treichville Tuberculosis Treatment Centre in Abidjan, and a follow-up of 6 months was observed for each patient. All in all, 41 patients were HIV-positive whereas 63 where HIV-negative. No statistical difference was noted between HIV-positive and HIV-negative patients with regard to the completion of therapy (85% versus 87%). The cure rate after an effective 6 month-therapy was similar among HIV-positive and HIV-negative patients (83% versus 84%) as well as the treatment failure rate which was 2.4% and 3% respectively. The results clearly indicate that the 6 month-short-course regimen policy implemented in Côte d'Ivoire is as effective for the treatment of HIV-associated tuberculosis as for the treatment of tuberculosis.

Acquired Immunodeficiency Syndrome↗