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  Time Line of TB in Canada

 1948 - Introduction of antimicrobials in treating tuberculosis patients


"The dawning of a new day occurred in 1944 with Waksman’s discovery of streptomycin, the first specific antibiotic that proved lethal to the mycobacterium (the bacteria causing tuberculosis). Isoniazid and PAS quickly followed and their prompt adoption for treatment and the prevention of recurrences produced miraculous consequences.

In 1948, some 7.2% of patients received streptomycin. By 1953, 77% of patients were on streptomycin. Para-amino-salicylic acid (PAS) came into use in 1950 and was common by 1952.

Isoniazid was introduced in 1953 and by the late 1950s most patients were receiving this powerful drug. Many patients were given this drug in combination, since it was found that two or more drugs together taken for an adequate period of time – usually 18 months to two years – prevented bacterial resistance. Triple therapy became firmly established by the mid-1950s.




 Years
 1867
 1882
 1896
 1900
 1905
 1919
 1921
 1923
 1925
 1929
 1933
 1935
 1944
 1947
 1948
 1948
 1948
 1950
 1953
 1963
 1967
 1968
 1980
 1985

Antimicrobial treatment, which shortened the duration of in-patient treatment, and a slow decline in the incidence of tuberculosis, led to a sudden surplus of [sanatorium] beds. Within 10 years after 1953, the number of TB beds had been halved, from 18,977 to 9,722. Even with this marked decrease in beds, total occupancy fell from around 90% in the early 1950s to around 70% ten years later. The average length of stay of patients had fallen to 7 to 8 months. Patients were required to continue their drug treatment for a prolonged period after leaving the sanatorium and an early study showed that there were deficiencies in the supervision of discharged patients… To date, although the course of treatment is now much shorter, ensuring that patients take their drugs for the required time remains a problem.
Reported tuberculosis incidence rates in Canada between 1925 and 1996.

Antimicrobial treatment had a profound influence on the tuberculosis mortality rate, which started dropping rapidly after streptomycin was introduced. While the rate had declined slowly, 3% annually on average between 1926 and 1946, it fell 12% annually over the next five years – the years antimicrobials came into use in Canada. Rates dropped even more sharply, by an average 20% each year, between 1951 and 1956 when antibiotic treatment became the norm.

The concept of sanatorium treatment as an essential part of treatment of tuberculosis persisted until the 1970s. By then, only a minority of patients were admitted to hospital, while most were treated as out-patients. Today, antimicrobial chemotherapy (drug therapy) is the only type of treatment prescribed by doctors for the treatment of tuberculosis." -- taken from "A Statistical Chronicle of Tuberculosis in Canada" report from Statistics Canada, 1992.