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At least 19 recordsLinked to original sources
PubMed1984

A comparison of the blood levels and urinary excretion of ethionamide and prothionamide in man.

The blood levels and urinary excretion of the anti-mycobacterial drugs ethionamide and prothionamide have been compared after oral dosage in man. High pressure liquid chromatographic methods were used to determine the two closely related thioamides and their microbiologically active sulphoxide metabolites after the ingestion of both single and combined doses of the two drugs. Both drugs were rapidly eliminated from the body, the half-life for the urinary excretion and removal from the plasma of prothionamide being slightly less than that of ethionamide. Less than 0.1% of the orally administered doses were excreted unchanged in the faeces. Plasma concentrations of ethionamide and its sulphoxide metabolite were substantially higher than those of prothionamide and prothionamide sulphoxide. The implications of these findings for the use of ethionamide or prothionamide in the treatment of lepromatous leprosy are discussed.

Biotransformation↗
PubMed2006

A clinical trial of ethionamide and prothionamide for treatment of lepromatous leprosy.

In 1982-1984 we conducted a six-month clinical trial in 50 previously untreated lepromatous leprosy patients randomly assigned to directly observed monotherapy with one of two thioamides, ethionamide or prothionamide, each given six times a week at doses of either 250 mg or 500 mg. The findings of this study have only recently been analyzed, and the potential for the use of these thioamides in leprosy patients placed in perspective. However, because of the small number of patients included in this study, the results must be interpreted with some caution. Clinical improvement was noted in 74% of the patients treated with ethionamide and in 83% of those treated with prothionamide. Therapy was well tolerated and drug-related hepatotoxicity did not require discontinuation of therapy. The 500-mg dose of both ethionamide and prothionamide resulted in loss in Mycobacterium leprae viability more rapidly than did the 250-mg dose, and prothionamide at both dose levels was superior to the equivalent dose of ethionamide. Overall killing of M. leprae in this study was found to be similar to that obtained previously with dapsone and clofazimine, but less than was obtained with rifampin, minocycline, clarithromycin, pefloxacin, and ofloxacin.

Adolescent↗
PubMedDate not supplied

Treatment of paucibacillary leprosy with a regimen containing rifampicin, dapsone and prothionamide.

Ninety paucibacillary leprosy patients having indeterminate (I), tuberculoid (TT) and borderline tuberculoid (BT) type of leprosy with bacterial index (BI) of less than two on the Ridley scale were treated with rifampicin (RFM) 600 mg once a month, dapsone (DDS) 100 mg daily and prothionamide (PTH) 250 mg daily. Treatment was stopped at the end of six months. The patients tolerated the drugs fairly well and in only two patients the drugs had to be stopped (in one due to jaundice and in the other due to gastric intolerance). About 6% of patients had early reactions which subsided with additional steroid therapy. The inactivity rate was 60% at six months and this improved to 96% at 12 months. No cases of late reactions and relapses were encountered in the limited follow-up period of six months; and a longer follow-up is necessary for ascertaining the relapse rates. The preliminary results however suggest that the addition of prothionamide to the standard WHO paucibacillary regimen is well-tolerated with increased inactivity rate and fewer instances of late reactions.

Adolescent↗
PubMedDate not supplied

Prothionamide and dapsone therapy in leprosy--a clinical study.

Combined therapy with prothionamide and dapsone was instituted in fifteen active untreated lepromatous leprosy cases for a period of 18 months. Clinical improvement was good with attainment of zero morphological index in about 66% cases. Bacteriological improvement was rather unsatisfactory as one case only reached zero level. Side effects were observed in few cases necessitating withdrawal of combined therapy and patients' prothionamide compliance was rather unimpressive.

Adult↗
PubMed1983

Sensitivity to capreomycin and prothionamide in strains of Mycobacterium, Nocardia, Rhodococcus, and related taxa for taxonomical purposes.

Sensitivity to capreomycin and to prothionamide was analysed for 150 strains belonging to the genera Mycobacterium, Nocardia, Rhodococcus, and related taxa. The analyses showed, e.g., that strains of Mycobacterium chelonei and Nocardia brasiliensis were more resistant to capreomycin than the other strains tested and that M. farcinogenes differed from M. senegalense concerning sensitivity to this drug. The analysis showed, furthermore, that strains of Mycobacterium differ from those of Nocardia, Rhodococcus, "Mycobacterium album", and "Gordona aurantiaca" in being more sensitive to prothionamide than these organisms. Strains designated N. amarae were more sensitive to both drugs than were the other tested strains of Nocardia, which indicates that N. amarae diverges from the other species of this genus.

Capreomycin↗
PubMed1982

The role of low dosage prothionamide with and without 4,4'-diamino diphenyl sulphone for use with isoniazid in the treatment of experimental mouse tuberculosis.

To determine whether or not low dosage prothionamide (PTH), with or without diamino diphenyl sulphone (DDS), can replace PAS or thiacetazone as the companion drug to isoniazid (INH) in the treatment of tuberculosis, two experiments have been performed in mice. In experiment I the 2-month effectiveness of 25mg/kg INH alone, INH+PTH (25mg/kg) or INH+PTH+DDS (10mg/kg) was investigated. Both PTH-containing regimens were equally effective in preventing the selection of INH-resistant mutants but PTH did not appear to add much to the bactericidal activity of INH. In experiment II the one year effectiveness of similar regimens supplemented by an initial month of streptomycin (SM) was investigated. Again PTH appeared very effective whereas DDS seemed ineffective. Therefore it seems that PTH is likely to be a good companion drug for INH when used in man at the dosage of 5mg/kg which is more or less equivalent to 25mg/kg in the mouse.

Animals↗
PubMed1979

On the mechanism of the antimycobacterial activity of isoniazid + prothionamide + dapsone (Isoprodian).

Increased antimycobacterial activity of Isoprodian (isoniazid + prothionamide + dapsone) may be due to (i) decreased mutation rate for INH resistance provoked in mycobacteria by DDS (in 2 of 3 strains tested); (ii) leakage of K+, Na+ or Ca++ caused by INH and/or by PTH (in all 3 strains tested), and (iii) indicating damages which may increase the low level penetration of DDS into the cell in sub-MIC concentrations as shown by phage proliferation changes (tested in 1 strain with 1 phage).

Adsorption↗
PubMed1980

Antimycobacterial activity of isoniazid + prothionamide + dapsone against a number of randomly selected 'wild' strains of Mycobacterium tuberculosis.

46 strains of Mycobacterium tuberculosis were studied as to their susceptibility to isoniazid (INH) or to INH + prothionamide (PTH) in the presence or absence of dapsone (DDS) by microdilution transfer plate technique. Synergy with DDS as defined by Berenbaum in 1978 was seen in 78% with INH and in 91% with INH + PTH. It concerned the minimal inhibitory concentration, whereas the minimal bactericidal concentration (MBC) was unaffected in the case of INH and it was increased in only 52% with INH + PTH. The latter MBC proportion mentioned would be decreased to roughly 16% accepting an only twofold decrease in the MBC as possibly due to dilution errors. The possible effect of dimethyl sulphoxide on the reported results is discussed.

Dapsone↗
PubMed1992

Does isoniazid increase the hepatotoxicity of the combination prothionamide-dapsone? Isoprodian Study Group.

In order to assess the potential additive liver toxicity of isoniazid to that of a thioamide-containing treatment, a prospective, randomized, double-blind trial of 24 weeks' duration involving 772 adult patients was conducted in four leprosy centers--two in India, one in Madagascar, and one in the Ivory Coast. Patients with multibacillary leprosy were given daily 100 mg dapsone (DDS) and 350 mg prothionamide (PTH) plus monthly 600 mg rifampin (RMP) in combination either with 350 mg isoniazid (INH) or with a placebo. After clinical and laboratory (including HBs-Ag testing) examinations on admission, the side effects (especially gastrointestinal disturbances and liver toxicity) were assessed at regular intervals during treatment by laboratory testing (aminotransferases, bilirubin, alkaline phosphatase) and by recording spontaneous complaints. Analysis of the frequency and seriousness of the side effects was made before breaking the code (with or without INH). Although 10% of the patients had liver toxicity leading to stopping treatment, no significant difference in the occurrence of side effects was observed between patients treated with or without INH. Most (75%) of the observed side effects occurred during the first 4 weeks of treatment, and the time of their onset was not related to INH. Body weight and age were factors related to the frequency of side effects [the higher the body weight, the lesser the rate of side effects (p = 0.03)] and the rate of serious side effects increased with age (p = 0.02). But, again, the frequency of the side effects was not related to INH administration. Therefore, from the present study it can be concluded that INH does not increase the toxicity of the thioamide-containing treatment.

Adolescent↗
PubMed1990

[Short- and long-term results of tuberculosis therapy with a fixed combination of isoniazide, prothionamide and diaminodiphenylsulfone combined with rifampicin].

This is a report on 912 patients treated during 1973 to 1979 for pulmonary tuberculosis and/or extrapulmonary organ involvement. These patients had been treated with a fixed tablet combination of isoniacide, prothionamide and diaphenyl sulfone in association with rifampicin and partly other substances. It was the aim of our study to examine this form of therapy in respect of side effects and effectivity. 535 of these 912 patients were followed up for as long as 13 years (maximum follow-up period). According to the criteria of the American Tuberculosis and Respiratory Diseases Association the patients were suffering from 182 cases of pulmonary tuberculosis of only slight extension, 490 of moderate extension and 130 of large extension, as well as 55 cases of pleuritis, 67 extrapulmonary organ tuberculoses and 1 tuberculosis of the bronchial mucosa. Allergic skin reactions occurred in 0.7% of the cases, and in 0.9% there were neurological disturbances such as vertigo, paroxysms and polyneuropathies. In 7.4% of the patients there was an increase in serum enzyme activities of SGOT, SGPT, Y-GT as a sign of hepatotoxicity. In 5.5% of the patients there were several gastrointestinal concomitant phenomena such as sensation of fullness, nausea, and vomiting. Under IPD therapy the hemoglobin valuedropped on the average by 12% up to the 5th or 6th week of treatment and rose subsequently to almost normal levels. No permanent damage was seen in any of the patients under observation. In the moderately extended tuberculosis cases disinfection occurred on the average between the 6th and 8th week of treatment, in the greatly extended cases on the average in the 9th to 13th week.(ABSTRACT TRUNCATED AT 250 WORDS)

Dapsone↗
PubMedDate not supplied

Hepatitis and multi-drug therapy in leprosy with special reference to prothionamide.

Hepatotoxicity in two drug regimens was studied at Central Leprosy Teaching and Research Institute, Chengalpattu (Tamil Nadu) during 1983-84. In 'P' regimen-prothionamide 350 mg daily, dapsone 100 mg daily and rifampicin 600 mg at monthly intervals were given. In' C' regimen-dapsone 100 mg daily, rifampicin 600 mg once a month and clofazimine 300 mg once a month and 100 mg alternate day were given. Trial was started with fifty multibacillary adult leprosy patients in each group. Enzymatic hepatic dysfunction was noted in 52-58 per cent of the cases even before the therapy was started. In 'P' regimen, four cases of clinical jaundice and six cases of high bilirubinaemia was noticed during the trial as against two cases each of clinical jaundice and high bilirubinaemia in 'C regimen. Of the two cases of clinical jaundice in 'C' regimen, one turned out to be a case of HBV infection. The study which is in progress, indicated higher hepatotoxicity in 'P' regimen which is probably explained by the simultaneous use of two hepatotoxic drugs. Viral hepatitis is endemic in this area and might have aggravated the hepatotoxicity observed.

Adolescent↗
PubMed1985

Failure of a prothionamide-containing oral antituberculosis regimen.

A group of 150 patients with sputum-positive pulmonary tuberculosis was treated with a regimen containing only orally administered drugs. Rifampicin and pyrazinamide were combined with Isoprodian, which contains isoniazid and also prothionamide and diaphenylsulphone. All the drugs were given daily for 5 months. Early analysis of the results shows 5 treatment failures, 27 relapses of pulmonary tuberculosis and another 17 patients who did not complete the prescribed regimen.

Administration, Oral↗
PubMed1983

Disposition of prothionamide in rats and armadillos.

A new method for the sensitive and selective measurement of prothionamide (PTH) and its S-oxide metabolite (PTHSO) in biological fluids was described. The limit of sensitivity was approximately 0.01 microgram of drug/ml of plasma. Endogenous materials, 2-propylisonicotinamide, ethionamide, dapsone, or monoacetyl dapsone did not interfere or contribute. Rats receiving PTH, intravenously or orally, showed a sexual dimorphism in the ability to oxidize PTH to PTHSO, with males exhibiting greater capacities for this conversion. Both sexes cleared the administered PTH more rapidly from the plasma than the metabolite, PTHSO. Following oral or intravenous administration of equimolar doses of PTHSO, both sexes exhibited an ability to reduce the administered PTHSO to PTH, with the female showing greater capacities for this conversion. Clearances after oral PTHSO administration were again more rapid for PTH than for PTHSO in both sexes. However, the total of PTH and PTHSO in the plasma during 8 hr following PTHSO administration was consistently less than following PTH dosing. Therefore, although PTHSO is retained longer than PTH after either PTH or PTHSO administration, giving PTHSO yielded less total active drug in the circulation. Comparison of plasma patterns of PTH and PTHSO in unfasted rats receiving one oral or eight daily oral doses of PTH did not indicate that PTH induces its own metabolism. Limited studies in armadillos receiving PTH and PTHSO intravenously led to the same general conclusions as those we derived from the rat studies regarding the disposition of PTH and PTHSO.

Animals↗