Treatments of Tuberculosis

Soon after streptomycin was introduced, sulfetrone was widely tried with it and found to reduce greatly the appearance of resistant strains of tubercle bacilli. But sulfetrone was rapidly supplanted by PAS which is more effective, while isoniazid is even better. As long as two drugs are used together the chances of the bacteria producing a strain resistant to either drug is very slender. If three drugs are used together the chances of a resistant strain arising are completely negligible – provided the original strain of bacteria were sensitive i.e. not resistant, to all three drugs.

We have at last learned that to give any anti-tuberculous drug by itself is to invite almost certain failure in the long run, because resistant strains will certainly develop. To a less extent the same applies to chemotherapy of all diseases. The indiscriminate use of valuable drugs like penicillin for trivial complaints has already produced numerous strains of the commoner bacteria resistant to penicillin, the sulfas, streptomycin, and even to aureomycin. In future perhaps chemotherapy will always be by two or three drugs used together for all infective diseases, while a wiser public will be less likely to demand chemotherapy for the most trivial infections, and a wiser medical profession will be less ready to accede to such demands. Apart from the risk to the community in spreading resistant strains of bacteria by indiscriminate use of chemotherapy, the individual patient runs a risk from unnecessary contact with these powerful and valuable drugs. This is the risk of becoming allergic or hypersensitive to the drug, so that the drug may have to be denied the patient in future when he might have serious need of it. Some people develop allergic symptoms of such severity that they are actually a threat to life. In view of the risk of spreading allergy amongst the human population and drug-resistance amongst the parasitic bacteria, the treatment of ordinary colds and minor infections with antibiotics valuable in other diseases is obvious folly, especially as none of the antibiotics so far discovered has any action on the common cold virus.