Sterling Timothy R
Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA.
Semin Respir Crit Care Med. 2008 Oct;29(5):532-41. doi: 10.1055/s-0028-1085704. Epub 2008 Sep 22.
It is estimated that one third of the global population is infected with MYCOBACTERIUM TUBERCULOSIS. Treatment of M. TUBERCULOSIS infection is an important strategy for tuberculosis elimination, but the effectiveness of this strategy is limited by poor adherence to therapy, which is due at least in part to the long duration of treatment. A 9-month course of isoniazid is the currently preferred treatment regimen for M. TUBERCULOSIS infection, due to the extensive data regarding the effectiveness and tolerability of isoniazid, and limited data on the effectiveness and tolerability of alternative shorter-course regimens. This review covers all currently available regimens, including less established alternative treatment regimens (e.g., rifampin for 4 months and isoniazid + rifampin for 3 months), as well as regimens that are currently under investigation (e.g., isoniazid + rifapentine for 3 months). Potential future regimens and experimental approaches are also discussed.
据估计,全球三分之一的人口感染了结核分枝杆菌。治疗结核分枝杆菌感染是消除结核病的一项重要策略,但该策略的有效性受到治疗依从性差的限制,而治疗依从性差至少部分归因于治疗疗程长。由于关于异烟肼有效性和耐受性的广泛数据,以及关于替代短疗程方案有效性和耐受性的有限数据,目前异烟肼9个月疗程是结核分枝杆菌感染的首选治疗方案。本综述涵盖了所有目前可用的方案,包括不太成熟的替代治疗方案(如4个月的利福平以及3个月的异烟肼+利福平),以及目前正在研究的方案(如3个月的异烟肼+利福喷丁)。还讨论了潜在的未来方案和实验方法。