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BMJ 1998; 317 doi: (Published 31 October 1998) Cite this as: BMJ 1998;317:1248

(Reprinted from BMJ 1948:ii:790-1)


In few infections is it so difficult to assess the results of treatment as in pulmonary tuberculosis, with its varied clinical picture and unpredictable course. Remarkable recoveries can take place with no treatment except rest in bed. In the Medical Research Council's trial of streptomycin in pulmonary tuberculosis, the report on which is published in this issue, there was a satisfactory control series of patients; this made it possible for the first time to make a fair estimate of the effects of the drug in one form of the disease. The method of investigation is discussed in the next leading article. The trial was designed to do no more than answer the question, Is streptomycin of any value at all in pulmonary tuberculosis? Although no attempt was made to determine either the types of disease likely to respond most favourably or the most effective dosage of the drug, much valuable information beyond the limited scope of the inquiry has in fact emerged.

The type of disease chosen was “acute progressive bilateral pulmonary tuberculosis of presumably recent origin, bacteriologically proved, unsuitable for collapse therapy, age group 15 to 25 (later extended to 30).” The treated (S) cases received 2 g. daily of streptomycin divided into four 6-hourly doses. Most patients were treated for four months, but some of the earlier ones for longer periods up to six months. The control (C) patients were treated by bed-rest alone in the same hospitals and with the same regime as the S cases apart from streptomycin administration. Although a few of the C patients became suitable for various forms of collapse therapy (artificial pneumoperitoneum with phrenic paralysis in all but one case) before the end of the observation period, these measures were not thought to …

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