Streptomycin and combined streptomycin-promizole treatment of miliary and meningeal tuberculosis in infants and children at the Los Angeles Children's Hospital has resulted in clear-cut arrests in seven patients, two of whom had meningitis. A much longer period of observation will be necessary before these patients may be considered cured. These results are incomparably better than the universally fatal outcome of both diseases in a large and unselected group of untreated cases which has been studied. Promizole, and possibly also para-aminosalicylic acid, should be given concurrently with streptomycin. As they are relatively harmless drugs, they should be given to ambulatory patients for a long period of time after arrest of the disease to decrease the likelihood of recurrence. If necessary, streptomycin may be given for longer than 90 days, or in second courses, since combined chemotherapy apparently delays the appearance of streptomycin-resistant strains of tubercle bacilli. The current pessimism with which many pediatricians view miliary and meningeal tuberculosis is unwarranted. Optimism will be rewarded with many more recoveries in the future.
展开▼
