Evening star., 1950-11-29
Streptomyein Delays
tuberculosis Deaths
Drug Does Not Cure MoIody
But Tests Show Its VuIue
By Thomos R. Henry

But Tests Show Its VuIue
By Thomas R. Henry
At the end of the war the new anti
biotic streptomycin was being hailed
as possible magic drug" against
tuberculosis.
It was highly effective against the
tubercle bacillus in test tubes. It ap-
peared to have considerable effect in
patients.
The picture, however, never was clear
cut. and all sweeping claims were dis
counted. An alarming phenomenon was
the ease with which the germs seemed
to develop immunity to the drug.
At that time streptomycin was in
quite limited production and arrange
ments for its distribution were made
through committee of the National
Research Council. 1t was decided that
the drug should be restricted, until sup
plies became more adequate, to investi-
gators in position to make scientific
appraisal Of its value. A major investi-
cation was carried on through grants
from the Public Health Service. Study
Of the effects of the drug over IL
months on SAL carefully selected
patients in II hospitals scattered over
the country was arranged.
Results Just Announced.
The results have just been announced
after exhaustive analysis, and they con-
stitute the best measure of the efficacy
OF the drug available to date. Evalua-
tion was difficult since so many factors
enter the tuberculosis picture, including
the possibility of spontaneous recovery.
Patients were divided into two groups
from one OF which streptomycin was
withheld. The general conclusion is
that the drug, while far from a cure,
has very great value when used with
the more conventional treatments.
tuberculosis cases, according to the
report just published, fall into three
classes. This possibly is due to inherent
constitutional makeup. One group Is
going to improve with conventional
treatments. or perhaps even with no
treatment at all. second group Is
going to get worse, almost regardless
OF what is done for them. There is
middle group which seems in the bal
ance. Unknown factors will turn 1t one
way or another.
The investigation showed clearly that
the improvement of the first group was
accelerated. Deterioration Of the second
group was slowed down and death def
initely delayed. A third group may get
better or get worse. This group was
very difficult to evaluate, but in general
the drug seemed to increase the number
who recovered and decrease the num-
Der Of those who went from bad to
worse. Among these people the anti
biotic may have its greatest value, ac-
cording to the report. 81
All in Same Stage.
All the subjects were in about the
same stage Of the disease when treat
ment was started. At the end of three
months improvement had taken place
in much larger proportion of the
streptomycin- treated patients, regard
less Of the group into which they fell.
At each succeeding point in time when
the two were compared, the superiority
OF the streptomycin group was marked,
although the differences between the
two groups became somewhat smaller.
The more favorable position Of the
patients who received streptomycin was
evident in all respects in which the
groups were ompared-temperatur
body weight, degree of bacteriological
infection and x-ray changes IN the
lungs. ~ - = j
Although differences between the two
groups decrease with. time, the report
states. the control group never over
comes the advantage gained by, the
streptomycin group during the first
three months and the superiority Of
those who received the drug still is
evident after II months
The effort of streptomycin appeared
most striking in the acute cases. During
the year in which the study was con-
Quoted the death rate was more than
double among those who had not rel
ceived the drug than among those given
streptomycin. The contrast in the SUBJ
acute group was less marked.
This does not mean. it is emphasized.
that the disease has been definitely
arrested in the acute group. Many Of
those in the group probably will go
from bad to worse. The lung changes
show by no means that improvement
which would be suggested by the
lowered death rate. But at least the
drug has delayed death.