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HONG KONG CHEST SERVICE/BMRC
firmation of many studies of experimental mur ine tuberculosis (11-15). This sterilizing action of pyrazinamide is clearly of value in short- course chemotherapy. Indeed, it has been sug- gested that this drug may have a unique steriliz- ing role in short-course regimens owing to its ability to kill slowly metabolizing bacilli in an acid intracellular environment (16). Thus, it probably kills a fraction of the bacterial popula- tion relatively unaffected by other antitubercu- losis drugs.
In Hong Kong there is a high prevalence of initial drug resistance among patients with new- ly diagnosed pulmonary tuberculosis, and stud- ies are now being done to find out whether the addition of a limited quantity of rifampin to short-course regimens will improve their thera- peutic efficacy both for patients with drug-sus- ceptible strains before treatment and for pa- tients with resistant strains.
Acknowledgment
In Hong Kong, the medical and laboratory staffs, the Medical Social Workers, Health Visitors, and Health Auxiliaries, and the nursing, radiologic, technical, secretarial, and administrative staffs of the follow- ing hospitals, chest clinics, and laboratory cooperated in the study. From the Anti-Tuberculosis and Tho- racic Diseases Association, Ruttonjee Sanatorium: Sister M. Aquinas, Sister M. Gabriel, Dr. C. A. Law- rence, Dr. Phillip Wong; Grantham Hospital: Dr. P. A. L. Horsfall, Dr. Michael Chan, Dr. K. S. Cheung, Dr. S. H. Tsang, Dr. Pau Wei, Dr. William Chen, Dr. K. C. Tang, Dr. H. S. Chau, Dr. R. P. Sak- sena. From the Junk Bay Medical Relief Council, Haven of Hope Sanatorium: Dr. P. K. Jenkins, Dr. R. G. B. Graham, Dr. Mary A. Ashton, Dr. David Lum. From the Government Chest Service, Wanchai Chest Clinic: Dr. J. M. Titmas, Dr. S. S. Leong, Dr. Albert Fong; Sai Ying Pun Chest Clinic: Dr. J. C. Luan, Dr. J. M. Chau; Shaukiwan Chest Clinic: Dr. A. Abraham, Dr. C. H. Ng; Yaumati Chest Clinic: Dr. George Kwong; Kowloon Chest Clinic: Dr. E. L. Wang, Dr. P. P. Cheung; Shek Kip Mei Chest Clinic: Dr. W. C. Loke, Dr. S. W. Fung; Kwai Chung Chest Clinic: Dr. P. G. Lindsay; Kowloon Hospital: Dr. H. Y. Wong, Dr. Francis Au. From the Government Pathological Institute: Dr. T, B. Teoh.
The London laboratory was the Medical Research Council Unit for Laboratory Studies of Tuberculosis (Professor D. A. Mitchison, Dr. G. A. Ellard, Mr. B. W. Allen).
The investigation was coordinated in Hong Kong by Dr. W. G. L. Allan. The Coordinating Secretary was Mr. Y. L. Chan. Dr. Dip Singh and Dr. S. C. Pang were independent assessors. In London the coordina-
tor was Dr. D. J. Girling of the Medical Research Council Tuberculosis and Chest Diseases Unit.
Der-
Ox,
The report was prepared on behalf of the ating physicians by Dr. D. J. Girling, Dr. Wallå Mr. A. J. Nunn, and Professor D. A. Mitchison.
All those cooperating are grateful to the Director of the Medical and Health Services, Hong Kong, for his interest and encouragement.
References
1. East African/British Medical Research Councils: Controlled clinical trial of short-course (6- month) regimens of chemotherapy for treatment of pulmonary tuberculosis, Lancet, 1972, 1, 1079. 2. Hong Kong Tuberculosis Treatment Services/ British Medical Research Council: Controlled trial of 6 and 9-month regimens of daily and intermittent streptomycin plus isoniazid plus pyrazinamide for pulmonary tuberculosis in Hong Kong, Tubercle, 1975, 56, 81.
3. Hong Kong Tuberculosis Treatment Services/ British Medical Research Council: Adverse reac- tions to short-course regimens containing strep- tomycin, isoniazid, pyrazinamide and rifampi- cin in Hong Kong, Tubercle, 1976, 57, 81.
4. East African/British Medical Research Councils: A controlled comparison of four regimens of streptomycin plus pyrazinamide in the retreat- ment of pulmonary tuberculosis, Tubercle, 1969, 50, 81.
5. Tuberculosis Chemotherapy Centre, Madras: A controlled comparison of a twice-weekly and three once-weekly regimens in the initial treat- ment of pulmonary tuberculosis, Bull WHO, 1970, 43, 143.
6. East African/British Medical Research Councils: Streptomycin plus pyrazinamide in the retreat- ment of pulmonary tuberculosis: second report, Tubercle, 1970, 51, 359.
7. Mitchison, D. A.: Bacteriological mechanisms in recent controlled chemotherapy studies, Bull Int Union Tuberc, 1970, 42, 322.
8. Dickinson, J. M., and Mitchison, D. A.: Obser- vations in vitro on the suitability of pyrazina- mide for intermittent chemotherapy of tuber- culosis, Tubercle, 1970, 51, 389.
9. East African/British Medical Research Councils: Controlled trial of four short-course (6-month) regimens of chemotherapy for treatment of pul- monary tuberculosis. Third report, Lancet, 1974, 2,237.
10. East African/British Medical Research Councils: Controlled clinical trial of four 6-month regi- mens of chemotherapy for pulmonary tuberculo- sis. Second report, Am Rev Respir Dis, 1976, 114, 471.
11. McCune, R. M., Jr., Tompsett, R., and McDer- mott, W.: Fate of Mycobacterium tuberculosis
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