L'ACTIVITE ET L'EFFICACITE DES ANTIBIOTIQUES ANTITUBERCULEUX. (INDICATIONS, RESULTATS, RESISTANCE)

The rational use of drugs for chemotherapy of tuberculosis requires that actively growing and slowly growing, extracellular and intracellular populations of tubercle bacilli are controlled. Isoniazid and rifampicin that are bactericidal on extracellular and intracellular populations are the major drugs. Streptomycin, like other aminoglycoside antibiotics, is bactericidal only on extacellular populations. Pyrazinamide is bactericidal only on intracellular populations. Other drugs have mainly a bacteriostatic activity on the bacilli whether the bacilli are located inside or outside cells. The combination izoniazid plus rifampicin is of course the most effective chemotherapy of tuberculosis. But the addition of streptomycin and pyrazinamide can increase furthermore the activity of the isoniazid-rifampicin combination. When isoniazid and rifampicin cannot be given together, effective alternatives could be isoniazid plus ethambutol or rifampicin plus ethambutol with an initial supplement of streptomycin (or kanamycin) and pyrazinamide.