The Relation of Cavity to the Development of Streptomycin-Resistant Tubercle Bacilli in Pulmonary Tuberculosis

Abstract

IT IS increasingly apparent that the usefulness of streptomycin therapy in pulmonary tuberculosis is seriously limited by the frequent and often early appearance of tubercle bacilli that are resistant‡ to the drug. The development of this resistance in vitro has been observed to coincide with loss of effectiveness of the drug in vivo.^{1 2 3 4} The incidence of streptomycin resistance has been found to increase with the number of days that treatment is given.^{1 , 3 , 5 6 7} It is believed, in addition, that resistant strains appear earlier and more frequently in patients with severe constitutional symptoms and in those with extensive pulmonary involvement.^{4 , 5} On the . . .