Intermittent chemotherapy with isoniazid and streptomycin in Algiers

From 1963 to 1966 the authors studied the effects of twice-weekly intermittent chemotherapy with isoniazid and streptomycin in 114 patients. The dosages of the drugs were 15 mg./kg. (13-17) body weight of isoniazid and 1 g. streptomycin twice weekly, for patients weighing 48 kg. on average. All patients were sputum positive on culture and 98%, had cavitation. Three regimens were successively studied: intermittent chemotherapy from the onset (regimen 1), intermittent chemotherapy after a 'short' initial phase of continuous chemotherapy (regimen 2), intermittent chemotherapy after a 'prolonged' initial phase of continuous chemotherapy (regimen 3). In the initial stage of continuous chemotherapy, patients were given daily isoniazid 10 mg./kg., PAS 10-12 g., streptomycin 1 g. 104 patients were given intermittent treatment for at least 2 months and some of them up to 24 months. Five 'failures' were recorded in regimen 1, two in regimen 2, none in regimen 3. Improvement, i.e. lasfing sputum negativity and x-ray improvement was reported in 93%. An initial phase of continuous chemotherapy seems desirable; its immediate therapeutic value is evident, while the effects of possible primary drug resistance-a relatively frequent occurrence in Algiers-may be prevented. The results achieved in this study contributed to the adoption of intermittent chemotherapy (isoniazid plus streptomycin twice weekly following a phase of continuous treatment of one to three months) as a standard national treatment schedule in Algeria.