The present status of isoniazid in the treatment of pulmonary tuberculosis.
نویسندگان
چکیده
After the sensational announcement of isoniazid as a remedy for tuberculosis a little over a year ago, it is highly proper a t this time to inquire about its present status-to assess its value and to describe its mode of action as much as the known facts will permit. There is no doubt that the first wave of enthusiasm was not entirely justified by subsequent trials in various forms of tuberculosis. I t fell considerably short of the ideal chemotherapeutic agent. For example, it is not definitely bacteriocidal and the bacilli soon gain resistance. On the other hand, it has achieved results that are equal to and perhaps superior to streptomycin in certain aspects of treatment of the disease. Combined with other drugs it constitutes a distinct advance in anti-tuberculosis therapy. There is no point a t this late date to go into the historical development of this interesting chemical. The early experiments were reported by several different laboratories and cl inic~. l -~ As an organic compound it is a relatively simple one. It was first prepared in 1912 and it lay on the chemists shelf for nearly 40 years before its usefulness in tuberculosis was discovered. As an agent against tuberculosis it may be compared to the keystone of the Arch of the Temple that was by-passed for a long period of time before its true place was found. I t must be pointed out that all of the actions and the exact mechanism of the action of this interesting chemical on the tubercle bacillus and on the human body, is by no means completely solved. There seems to be little question that there is a stimulating effect upon the body that is not possessed by any other anti-tuberculosis agent although streptomycin does create some feeling of well being due perhaps to the cutting off of toxins caused by the disease. There seems to be, on the part of isoniazid, a direct cerebral stimulation over and above that on the disease thus causing a feeling of well being and a stimulation of appetite. It may be due to the fact that the niacin fraction of the isoniazid may possess an action on the body over and above that produced by the action on the tubercle bacillus. The action on the tubercle bacillus itself has been studied by various workers with the result that much has been learned concerning the mech-
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عنوان ژورنال:
- Diseases of the chest
دوره 25 4 شماره
صفحات -
تاریخ انتشار 1954