4. 3. Era of short course chemotherapy

Chemotherapy of TB has undergone revolutionary changes in the seventies owing to the availability of two well tolerated oral bactericidal drugs – rifampicin and pyrazinamide. Short Course Chemotherapy (SCC) implies a new rationale of chemotherapy and not merely administering formally accepted regimens for short periods. By using these regimens it has now not only become possible to simplify treatment and reduce its duration, but it is also possible to improve the efficacy of treatment. Discovery of rifampicin in 1967 is considered as one of the greatest achievements in the history of development of anti-TB drugs. After its discovery no new drug has been found nor is in the offing. However, one should not forget that INH is still the queen of all drugs and if we wish to have a new drug(s) it should be comparable with INH. In the words of Dr Wallace Fox : “INH, the wonder drug of 1950’s is (and is likely to remain) the standard drug to be given for the full duration of all SCC regimens because of its efficacy and high early bactericidal activity, its small bulk and low toxicity. However, laboratory evidence suggests that the sterilizing role of INH is less than those of rifampicin and pyrazinamide. In planning short course regimens the choice the physician faces is what drugs should be added to INH”97. Dr Fox is considered as the father of clinical trials for chemotherapy of TB.

Dr. Wallace Fox, Director BMRC, UK Father of Chemotherapy