Medical academic journalMedical academic journal1608-41012687-1378Eco-Vector1007310.17816/MAJ10284-90Research ArticleThe influence of different doses of isoniazid at the time of sputum smear conversion among patients with drug-sensitive pulmonary tuberculosisMaryandyshevA Omarvandshev@mail.ruAndreevaO A-PerhinD V-ChichurinaE N-MironukO M-NikishovaE I-15062010102849003092018Copyright © 2010, Maryandyshev A.O., Andreeva O.A., Perhin D.V., Chichurina E.N., Mironuk O.M., Nikishova E.I.2010The main aim of our study was to estimate the influence of different doses of isoniazid 5 and 10 mg/kg in the combination with the other antituberculosis drugs at the time of sputum smear conversion among patients with drug-sensitive pulmonary tuberculosis. We carried out cohort prospective study of 77 patients with new cases of tuberculosis or relapse. The patients received treatment in the 3 department of the Regional Clinical ТВ Dispensary, Arkhangelsk, since April, 2008 till Aprill, 2009. A comparative analysis on 2 regimens of antituberculosis treatment was carried out. It included: rifampicin (10 mg/kg), pirazinamid (30 mg/kg), etambutol (25 mg/kg) and isoniazid 5 mg/kg (group 1) or 10 mg/kg (group 2). At the end of the intensive phase of treatment intoxication and clinical manifestations disappeared in all the patients of group 1 and group 2. The mean time from the initiation of appropriate therapy to sputum smear conversion in two groups were approximately the same (Me=3,00, Q1=1,00, Q3=8,50 и Me=3,00, Q1=1,00, Q3=7,00).The patients from group 1 and group 2 had the same rates of sputum smear conversion at the 1 week (RR=0,938, 95%Ci=0,468-1,635) and at the 1 month of treatment (RR=1,036, 95%CI=0,741-1,447). By the end of the intensive phase (3 month) 35 (79,8%) patients from groupl and 30 (90,9%) patients of group 2 have converted by smear (RR=0,875,95%C1=0,727-1,052). By the end of intensive phase all patients reached sputum culture conversion and had positive radiological changes. The patients in both groups, where different doses of isoniazid (5 and 10 mg/kg) in the combination with other antituberculosis drugs were used, demonstrated a high effectiveness of treatment. No statistically significant differences in the time of sputum smear conversion in both groups were found.'tuberculosisisoniazidsputum smear conversionтуберкулезизониазидконверсия мазка мокроты[Браженко Н.А., Браженко О.Н. Фтизиопульмонология. М.: Академия, 2006. С. 266-267.][Васильев А.В. Современные проблемы туберкулеза в регионе Северо-Запада России // Пробл. туб. 1999. №3. С. 5-7.][Визель А.А., Гурылева М.Э.Туберкулез. М., 1999. С. 281-284.][Мишин В.Ю., Стрелис А.К., Чуканов В.И. и др. Лекции по фтизиопульмонологии. М.: ООО «Медицинское информационное агентство», 2006. С. 230-232.][Перельман М.И., Корякин В.А., Богадельникова И.В. М.: Медицина, 2004. С. 426^127.][Приказ Министерства здравоохранения и социального развития от 21 марта 2003 года № 109 «О совершенствовании противотуберкулезных мероприятий в Российской Федерации». М., 2003.][Brindle R., Odhiambo J., Mitchison D. Serial counts of Mycobacterium tuberculosis in sputum as surrogate markers of the sterilizing activity of rifampicin and pyrazinamide in treating pulmonary tuberculosis // BMC Pulm. Med. 2001. Vol. P. 2-8.][Dominguez-Castellano A., Muniain M.A., Rodriguez- Bano J. et al. Factors associated with time to sputum smear conversion in active pulmonary tuberculosis // Int. J. tuberc. Lung. Dis. Vol. 7. № 5. P. 432-436.][Donald P.R., Sirgel F.A., Botha F.J. et al. The early bactericidal activity of isoniazid related to its dose size in pulmonary tuberculosis // Am. J. Respir. Crit. Care Med. 1997. Vol. 156. P. 895-900.][Global Tuberculosis Control. Surveillance, Planning, Financing. WHO report 2005 // World Plealth Organization. Geneva, 2005.][Jindai A., Aber V.R., Edwards E.A., Mitchinson D.A. The early bactericidal activity of drugs in patients with pulmonary tuberculosis // Am. Rev. Respir. Dis. 1980. Vol. 121. P. 939-949.][Masako WADA, Takashi Yoshiyama, Hideo Ogata. Six-months chemotherapy (2HRZS or E/4FIRE) of new cases of pulmonary tuberculosis // Kekkaku. 1999. Vol. 74. № 4. P. 353-360.][Mitchison D.A. Role of individual drugs in the chemotherapy of tuberculosis // Int. J. Tuberc. Lung. Dis. 2000. Vol. 4. № 9. P. 796-806.][Rider H.L. Intervention for Tuberculosis Control and Elimination. International Union Against Tuberculosis and Lung Disease, 2002.][TelzakE.E., Fazal B.A., Pollard C.L. et al. Factors influencing time to sputum conversion among patients with smear-positive pulmonary tuberculosis // Clin. Infect. Dis. 1997. Vol. 25. P. 666-670.]