Past development, present status and future prospects of combined chemotherapy of human tuberculosis

Acocella, G. (1983) Past development, present status and future prospects of combined chemotherapy of human tuberculosis. Indian Journal of Tuberculosis, Supplement, 30 (3). pp. 29-31.

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Abstract

While search for an ideal drug continues, use of available drugs should be optimised. The object of multiple drug combinations is not merely to prevent the selection of resistant mutants but also to ensure bactericidal action in respect of various subgroups of the bacillary population of a lesion in respect of their metabolic and growth characteristics. Pharmacokinetic studies have shown that the drugs do not interfere with each other’s action and all the three oral bactericidal drugs can be administered in a single preparation, thus reducing the number of pills/ capsules to be swallowed by the patient and the possibility of the patient omitting one or the other drug inadvertently. SM, INH, RMP and PZA reach their peak concentration approximately 2 hours after administration, the peak being 20-30 meg/ml in the case of SM and PZA and 10-12 meg/ml for RMP and INH. There are, however, marked inter-individual and intra-individual variations in absorption and excretion of drugs and their effectiveness is related more to the height of the peak blood levels achieved than their half-life.

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