Isonicotinic acid hydrazide (rimifon) in the treatment of tuberculosis.

Following reports on the effectiveness of isonicotinic acid hydrazide in the treatment of tuberculosis,’ a clinical trial was instituted at the San Angel Sanatorium in Mexico City. Beginning in March 1952, a series of 13 hospitalized and 12 ambulatory patients were started on therapy with Rlmifon* and the results evaluated at the end of a 90-day period. The hospitalized patients selected for study were those known to be resistant to streptomycin and para-aminosalicylic acid, in whom all other procedures, medical and surgical, had been found ineffective. In addition, these patients were under observation for many months and in each instance, there was no evidence of spontaneous improvement. Throughout the study an attempt was made to maintain the same circumstances of environment, rest, and food as during the previous therapeutic regime, except that increased food allowance was provided if specifically requested by the patient. No other medication was administered. The ambulatory group was composed chiefly of former patients of the Sanatorium having less serious infection who were observed weekly in the clinic. The following procedures were carried out for critical evaluation of the effects of therapy: Roentgeno grams: Previous roentgenograms were reviewed and a new film was taken prior to instituting therapy. Fluoroscopy was done weekly and a film made every 30 days. Tomograms were taken when necessary. Hematology: Hematologic examination was made monthly of erythrocytic and leukocytic changes. Sputum Examination: Prior to treatment with isoniazid, examination was made to confirm resistance to streptomycin and para-aminosalicylic acid. Culture of the Mycobactenium in sputum obtained by concentration or gastric lavage was made before treatment and at 30-day intervals. Biochemical Examination: Sedimentation rate and determination of albumin-globulin ratio in the blood were regularly performed. Tests for liver and kidney function, and urine analyses, were made at the start of the study and repeated as necessary during the course of treatment. Clinical observations were made daily. The dosage used in this series, with one exception, was 4 milligrams per kilogram of body weight per day throughout the 90-day period. Adminis-