Tibione in the Treatment of Tuberculosis Activity, Dosage and Toxic Manifestations

Abstract

This study comprises a group of 75 patients with moderately and far advanced pulmonary tuberculosis treated with amithiozone or with amithiozone and streptomycin and/or PAS for periods varying from six to 10 months. Amithiozone shows marked anti-tuberculous activity in vitro and in animals. A hematologic crisis is described in a patient who received 300 mg. of amithiozone daily, but whose blood was unaffected on a dosage of 150 mg. daily for a period of 11 months. In daily dosage of 150 mg. or less, amithiozone is a safe drug when administered under medical supervision and with adequate laboratory facilities. In daily dosage of 150 mg., amithiozone may be administered for prolonged periods of time. In daily dosage of 150 mg., amithiozone may cause depression of any or all of the formed elements of the blood, but these alterations are transitory and restitution occurs with continued medication. In daily dosage of 150 mg., amithiozone may cause a transient eosinophilia. These studies do not indicate any specific effect of amithiozone on the sedimentation rate with relation to regression or progression of the disease. Chronic pulmonary tuberculosis appears to be a disease characterized by hyperproteinemia and hyperglobulinemia. Amithiozone heightens or maintains the hyperproteinemia and hyperglobulinemia. Cephalin flocculation tests of 2+ and 3+, after 48 hours, are not rare under amithiozone therapy and may be reversible with continued medication. Amithiozone may occasionally be responsible for hepatic insufficiency, jaundice, and hepatomegaly, but this reaction is reversible, and the drug may be resumed when the condition has subsided. Amithiozone may cause gastrointestinal disturbances of mild to severe intensity which disappear on cessation of medication and which are less likely to recur when the drug is resumed. In daily dosage of 150 mg. per centage amithiozone, conversion of sputum, and clinical improvement was noted. This will be evaluated and reported later. Combinations of amithiozone with streptomycin and of amithiozone, streptomycin and PAS seem to show greater clinical promise than any one of these substances used alone, but the results are still to be determined.