How did streptomycin change the treatment of tuberculosis in the 1940s?

In the 1940s, the discovery of streptomycin by Selman Waksman and his colleagues revolutionized the treatment of tuberculosis by providing the first effective antimicrobial agent against the disease. Prior to this breakthrough, medical care for tuberculosis was largely limited to long-term bed rest and surgical interventions, such as the removal of damaged lung tissue.1234

Streptomycin’s introduction marked a pivotal shift toward chemotherapy, allowing for the direct treatment of the underlying infection. However, clinicians soon discovered that the tubercle bacillus often developed resistance to the drug when used alone. To address this, medical practice evolved to include combination therapy, pairing streptomycin with other agents like para-aminosalicylic acid and later isoniazid. This shift toward multi-drug regimens significantly improved patient outcomes and established the foundation for modern tuberculosis control, eventually making surgical treatment for the disease rare.1324