Prelinary clinical observationsindicate that that, in general, a persongs to a rapid
inactivator my demonstrates suboptimal response to isonse to isoniazid therapy. In
contrast, the patients who belongs to a slow inactivator is much ore likely to achieve
optimal response to isoniazid therapy. Furthermore, a significant relationship has been
demonstrated between isoniazid metabolism and catalase cetivity, drug susceptibility of
tubercle bacilli, and toxicity of isoniazid. Patients with high serum isoniazid values (i. e.,
slow inactivators) are more likely to excrete catalase-negative, isoniazid-resistants,
whereas those patients are rapid inactivators and who have low serum isoniazid
concentations more often excrete catalase-positive, isoniazid sucilli. Peripheral neuritis is
the most commonly observed toxic effect. Although patients who are slow inactivators
ard mord likely to experience maximal antimierobil results, they are also more likely
develop peripheral neuritis. The purpose of this study is to determine the clinical
implications of the isoniazid metabolis ms in Korean.
RESULT
1. Four hundred and nity-seven pulmonary tuberculosis patients were treated with
INH(4-16㎎/㎏)-PAS(10-12gm.) and the clinical efficacies were analyzed by the isoniazid
metabolic patters and its doses.
2. In minimal cases there were no significant differences between therapeutic efficacies
and metabolic patterns of isoniazid.
3. In moderately advanced cases, particularly in rapid inactivators, high doses of INH
(8-16㎎/㎏)-PAS were superior than conventional daily dose of INH (4㎎/㎏)-PAS.
4. Peripheral neuritis occured more frequently in the high doses of INH(8-19㎎/㎏)
groups, predominantly in slow inactivators.
5. Patients who are rapid inactivators excreted isoniazid sensitive bacilli predominantly,
whereas patients who are slow inactivators excreted soniazid-resistant bacilli
predominantly.
6. Considering the clinical efficacy and toxicity, the optimal daily doses of isoniazid in
moderately advanced and far advanced cased were 8-16㎎/㎏ in rapid inactivators, 4-8㎎
/㎏ in rapid inactrvators, 4-8㎎/㎏ in intermediate an slow inactivators.
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