Combined Drug Treatmentof Tuberculosis . Iv . Bac - Teriologic Studies on the Sputum and Resected

The altered response to antituberculous agents of both the tubercle bacilli cultured from the sputum and from excised pulmonary lesions during and after therapy with these drugs has aroused the interest of the bacteriologist, the pathologist and the clinician. Therefore, many studies of this problem based upon clinical material subjected to wide varieties of drug-treatment regimens have been reported. These investigations have indicated that a significant proportion of clinically inactive lesions resected from drug-treated, sputumnegative patients still contain viable tubercle bacilli (1-7). For this reason surgical excision of roentgenographically demonstrable residual lesions is widely practiced. The purpose of this paper is to present a comparison of the preoperative and postoperative sputum results, including drug-susceptibility testing, with similar bacteriologic studies carried out on the specimens of pulmonary tissue removed at surgery from 220 tuberculous patients. These bacteriologic findings have also been correlated with the drug-treatment regimens used at National Jewish Hospital before and after October 1, 1954, including the results of bacteriologic examination of resected pulmonary lesions from 37 patients who had been originally treated with the high dosage combined-drug regimen described in the third paper of this series (8).