Short-course chemotherapy for pulmonary tuberculosis with a rifampicin-isoniazid-pyrazinamide combination tablet

S Afr Med J. 1990 Apr 21;77(8):390-1.


The effectiveness of a tablet containing a combination of rifampicin, isoniazid and pyrazinamide (Rifater; Mer-National) in the treatment of pulmonary tuberculosis was examined by comparing it with a previously evaluated four-drug regimen. Of 150 black goldminers with a first case of pulmonary tuberculosis, 69 were randomly allocated to receive the combination tablet (RHZ), 5 tablets per day on weekdays for 100 treatment-days, and 81 the four-drug regimen (streptomycin, rifampicin, isoniazid and pyrazinamide) (RHZS). Non-compliance was detected in 42% of the RHZ group and in 16% of the RHZS group. Two patients in the RHZ group and 4 in the RHZS group had to have their treatment altered because routine investigations revealed drug-resistant mycobacteria. Treatment was unsuccessful in 10 patients in the RHZ group, with 4 men failing to complete the regimen and being lost to follow-up, 3 cases of failure of conversion of sputum on the regimen, and 3 relapses. The results for the RHZS group were similar, with 4 failures to complete the regimen, 2 treatment failures and 4 relapses. Evaluation of RHZ showed it to be comparable with a previously evaluated, successful short-course regimen (RHZS). The high incidence of non-compliance probably reflects reduced supervision of this wholly oral regimen.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Antitubercular Agents / administration & dosage*
  • Drug Combinations
  • Drug Therapy, Combination
  • Humans
  • Isoniazid / administration & dosage
  • Isoniazid / therapeutic use*
  • Male
  • Middle Aged
  • Pyrazinamide / administration & dosage
  • Pyrazinamide / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Rifampin / administration & dosage
  • Rifampin / therapeutic use*
  • Streptomycin / administration & dosage
  • Tablets
  • Tuberculosis, Pulmonary / drug therapy*


  • Antitubercular Agents
  • Drug Combinations
  • Tablets
  • isoniazid, pyrazinamide, rifampin drug combination
  • Pyrazinamide
  • Isoniazid
  • Rifampin
  • Streptomycin