[Re-evaluation of pyrazinamide]

To re-evaluate pyrazinamide (PZA) which has been a key drug for short course anti-tuberculosis chemotherapy in the world, we started a clinical trial of short course chemotherapy containing PZA (2S (E) HRZ/EHR), and obtained information about the estimation of PZA in the tuberculosis specialists in Japan through a questionnaire. We could not evaluate precisely because of small numbers of registered cases, but the rate of negative conversion by culture was higher at the second months in the PZA group than in the control group. Although the total incidence of the adverse reactions of any kind was higher in the PZA group, the incidence of liver dysfunction was lower in the PZA group. Only about 20% of the tuberculosis specialists choose PZA in the treatment of newly diagnosed tuberculosis patients. The remainder do not choose PZA because they think that; 1) PZA has adverse reactions, 2) PZA is effectless, 3) drugs other than PZA are good enough. Almost half of the tuberculosis specialists continues antituberculosis chemotherapy for more than 9 months. The precise and strict nation-wide co-operative study for PZA should be designed to clarify the usefulness of PZA.