RIFAMPIN-COMBINED CHEMOTHERAPY IN COAL-WORKERS PNEUMOCONIO-TUBERCULOSIS

Abstract

Results of a retrospective study of rifampin-combined chemotherapy in 59 coal miners with pneumoconio-tuberculosis are reported. In 43 patients pneumoconiosis attained the stage of progressive massive fibrosis. The follow-up period ranged from 24-78 mo., except in 8 patients who died before the 24th mo. Twenty-seven of the 59 patients were treated for the 1st time and 32 were in retreatment. In none of them was rifampin administered before. Although the objective was to administer rifampin in combination with 1, 2 or even 3 companion drugs that were not administered before and that were active on the patients'' bacilli in vitro, this goal was fully reached only in the 1st treatment group; in 8 of the 32 retreated patients the drugs combined with rifampin were considered ineffective. The speed and rate of bacteriologic conversion were most impressive. Sputum conversion was obtained in 90% of the patients; in the initial treatment group 100% of the patients converted their sputum on culture at 5 mo. and in the retreatment group the corresponding figure was 84.4%. These bacteriologic results are nearly as favorable as those obtained in cases of advanced pulmonary tuberculosis without pneumoconiosis treated with the same rifampin-containing drug regimens. Rifampin-combined chemotherapy largely eliminates the handicap caused by the coexistence of tuberculosis and pneumoconiosis. Side effects due to rifampin were without practical significance. In 3 patients of 57 treated with ethambutol, visual impairment was observed. Mortality was high (27%) but was caused by nontuberculous diseases, especially cardiorespiratory insufficiency. In 10 of the 16 patients who died, death occurred after bacteriologic conversion.