Interventions for Tuberculosis Control and Elimination 2002
Interventions for Tuberculosis Control and Elimination 2002
Interventions for Tuberculosis Control and Elimination 2002
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Table 9. Grading of activities of anti-tuberculosis drugs. Reproduced from 456 by<br />
the permission of the publisher Churchill Livingstone.<br />
Extent of activity Prevention Early Sterilizing<br />
of resistance bactericidal<br />
High isoniazid isoniazid rifampicin<br />
rifampicin pyrazinamide<br />
ethambutol<br />
ethambutol rifampicin isoniazid<br />
streptomycin<br />
streptomycin streptomycin<br />
pyrazinamide pyrazinamide thioacetazone<br />
Low thioacetazone thioacetazone ethambutol<br />
Early bactericidal activity<br />
Early bactericidal activity is defined as the ability of the drug to kill tubercle<br />
bacilli in the first few days of treatment. 24,25,456 In a study measuring<br />
sputum colony counts in newly diagnosed tuberculosis patients treated with<br />
a multitude of monotherapy <strong>and</strong> multidrug therapy regimens during the first<br />
two weeks of treatment, no other drug or drug combination was superior<br />
to isoniazid alone in the first two days of treatment (figures 30 <strong>and</strong> 31). 24,25<br />
This high early bactericidal activity of isoniazid was subsequently confirmed.<br />
26,457 It is likely that the rapid reduction in infectiousness seen in<br />
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Figure 30. Early, two-day bactericidal activity of anti-tuberculosis drugs, measured<br />
as the reduction in colony-<strong>for</strong>ming units in sputum. 24<br />
51
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