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폐결핵치료에 현시개념

CURRENT CONCEPTS IN TREATMENT OF PULMONARY TUBERCULOSIS

대한의학협회지 1960년 3권 9호 p.36 ~ 39
WIER, JAMES A.,
소속 상세정보
 ( WIER, JAMES A. ) - Eighth U.S. Army

Abstract


Today the best results in treatment of tuberculosis follow use of combinations of our three standard drugs Streptomycin (SM), Isoniazid (INH) and Para-aminosalicylic acid (PAS). In our experience adequate doses of these drugs will produce arrest of active disease in over 99 % of patients with tuberculosis who have tubercle bacilli fully susceptible to the drugs being used and who. can tolerate the drugs. This without bed rest being used except in selected cases. We presently use
1. SM. 1 gm. daily till sputum conversion.
2. INH. 12-16 mgm. /kgm. daily with pyridoxine 100 mgm. ; modifying the dose on basis of serum level of active INH.
3. PAS. 12 gms. daily.
For milder, cases principally non-cavitary tuberculosis, we use INH and PAS but generally have added, streptomycin for the more severe case until sputum conversion has been obtained with INH-PAS continued for approximately 18-24. months total treatment.
In these cases with organisms susceptible to SM-PAS and INH bed rest is not reduired after acute symptoms have subsided and, indeed recently we have added progressive exercise to our programs without ill effect, starting within 2-3 weeks of admission even in patients with for, advanced cavitary disease. These patients start with active calisthenics and progress to active competitive sports and full time work. Resectional surgery has been added as necessary, early for removal of localized cavities.

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