A STUDY ON THERAPEUTIC EFFECT OF ENVIOMYCIN (TUBERACTIN) IN RETREATMENT FOR PULMONARY TUBERCULOSIS

• Published in: Kekkaku Vol. 53; no. 2; pp. 107 - 113
• Main Authors: NAGAI, Shunzo, OKAMOTO, Sachiko, YAMAMOTO, Kazuo, KITATANI, Fumihiko, ASAHI, Toshiko, IWAI, Kenichi, IWATA, Shinsaku, MATSUTANI, Yukiyoshi, KOBAYASHI, Masako, SUGIHARA, Fusako, YAMAGUCHI, Sakimori, YAMAZAKI, Masayasu, BESSHO, Mutsumi, MITSUFUJI, Yoshimi, WATANABE, Yoshimasa, NISHIZAWA, Natsuo, YUBA, Mitsuko, FUKUI, Shigeru, NAKATA, Seiichi, INOUE, Ikunoshin, SAWAI, Akira, TATSUMI, Nobuo, TSUJIMOTO, Takehiro, AIZAWA, Harumi, KONISHIIKE, Joichi, KAKUNO, Jutaro
• Format: Journal Article
• Language: English; Japanese
• Published: Japan JAPANESE SOCIETY FOR TUBERCULOSIS 01.02.1978
• Subjects: Adult; Antibiotics, Antitubercular - therapeutic use; Drug Evaluation; Enviomycin - administration & dosage; Enviomycin - therapeutic use; Female; Humans; Male; Tuberculosis, Pulmonary - drug therapy
• ISSN: 0022-9776; 1884-2410
• DOI: 10.11400/kekkaku1923.53.107

Enviomycin (EVM, Tuberactinomycin) is a new anti-tuberculous agent isolated from the culture of Streptomyces griseoverticillatus var. tuberacticus N6-130. This report presents the result of a co-operative clinical study at 11 tuberculosis hospitals in Osaka region on therapeutic effect and side-effects of Enviomycin in 189 retreatment cases of drug resistant pulmonary tuberculosis with cavities. The duration of EVM treatment has been fixed for six months and the drug was administered by intramuscular injections at the dose of 1 gram once daily for the first three months and twice weekly thereafter combined with other antituberculous drugs which had been used orally just prior to EVM treatment. The results are summarized as follows: 1) Background factors of 189 cases are shown in Table 1. The majority of cases (71%) were far-advanced tuberculosis and 47% of total cases were resistant to four or more anti-tuberculous drugs. The time course of EVM therapy is summarized in Table 2 including 143 completed cases of six months treatment. 2) Negative conversion of bacilli in sputa by smear and culture are shown in Tables 3 and 4. The sensitive group which has been treated with EVM and other unused drugs gives the higher negative conversion rate at sixth month by culture (67%) than the resistant group in which only already-used drugs were combined with EVM (27%). 3) Changes in basic lesions and cavities on chest radiograms are shown in Table 5. Improvements on chest radiograms were scarcely observed, as the most cases had chronic lesions and cavities with sclerotic wall to which no chemotherapeutic agents had been expected to react effectively. 4) The resistance against EVM was measured at 25 and 100μg/mlglml EVM containing Ogawa's egg media. The emergence of EVM resistance to 100μg/mlg/ml EVM at sixth month was 27.6% in EVM sensitive group. On the other hand, in another group which had shown 25μg/ml resistance against EVM at the start, all cases showed resistance to 100μg/ml EVM at sixth month (Table6). 5) Side-effects such as tinnitus, hearing drop, dizziness and headache which were assumed to be caused by EVM were observed in 27 cases (14.3%), and 15 cases of them (7.9% of total 189 cases) had dropped out from the therapy. 6) Hearing drop over 20 db at 8, 000 cis was observed in 12 cases (6.5%), however, only one case dropped out by this reason. In conclusion, enviomycin (EVM, Tuberactinornycin) has been proved to be one of usefulanti-tuberculous drugs which can be used daily in combination with other effective oral drugs in retreatment of resistant pulmonary tuberculosis, as the incidence of side-effects, especially hearing impairment was relatively low.