EVALUATION OF STREPTOMYCIN THERAPY IN A CONTROLLED SERIES OF NINETY CASES OF SKELETAL TUBERCULOSIS

A Public Health Service Cooperative Investigation

Ninety patients with skeletal tuberculosis, forty of whom were treated without streptomycin and fifty of whom were given at least one course of streptomycin in a daily intramuscular dose of twenty milligrams per kilogram of body weight for ninety-one days, were observed for a fifteen-month period.

The small numbers in the control and streptomycin groups limit the conclusions which may be drawn from the findings, namely that:

1. On the basis of x-ray evidence alone, the condition of the control and streptomycin groups was essentially the same; more than four-fifths of the patients in each group showed improvement roentgenographically at the end of fifteen months.

2. On the basis of the patient's condition as judged by x-ray and clinical data combined, there was a definite superiority among the streptomycin-treated patients. At fifteen months only 72 per cent. of the control group evidenced improvement, whereas improvement was noted for 79 per cent. of the streptomycin group as early as three months and for 89 per cent. of this group at fifteen months.

3. The action of streptomycin appears to produce a generalized effect upon the well-being of the patient with skeletal tuberculosis, and upon the secondary manifestations of the tuberculous process as illustrated by cessation of sinus drainage, reduction in the sedimentation rate, return towards a normal hemoglobin level, and evidence of greater improvement in functional ability.

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