SCHEMAS THERAPEUTIQUES DE LA TUBERCULOSE PULMONAIRE

In industrialised countries, standard treatment for pulmonary tuberculosis now lasts nine months. During the first two months, it is based upon the daily administration of isoniazid (5 mg/kg), rifampicin (10 mg/kg) and ethambutol (20 mg/kg), and during the subsequent seven months on the daily administration of isoniazid and rifampicin. This treatment can be reduced to six months without any decrease in efficacy if pyrazinamide is added at a daily dose of 35 mg/kg during the first two months. In countries with less financial resources, though still sufficient, standard treatment is based upon the triple combination of isoniazid, rifampicin and pyrazinamide and lasts for six months. Finally, in countries with very limited resources, rifampicin cannot be used routinely and treatment continues to be based upon the triple combination of isoniazid, streptomycin and thioacetazone administered for a minimum period of twelve months. In every case the success of treatment is dependent essentially upon the regularity with which antibiotics are taken by the patient, i.e. the quality of the medico-social organisation of treatment.