Guy Elizabeth S, Mallampalli Antara
Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Ther Adv Respir Dis. 2008 Dec;2(6):401-8. doi: 10.1177/1753465808099522.
With an estimated one-third of the world's population infected with Mycobacterium tuberculosis (MTB) and approximately 1.6 million deaths in 2006 attributed to tuberculosis (TB) world-wide, TB remains a major public health concern today. Considerable advances have been made in the effective treatment of TB, in particular with the adoption of directly observed therapy short course (DOTS), in national TB control programs, but in spite of this the currently available regimens are suboptimal. The long courses of therapy required, together with significant medication side-effects and resulting difficulties with adherence to therapy all contribute to increasing problems with emerging drug resistance. There is thus an urgent need for new antituberculous drug development, especially to enable effective shorter course therapy for drug-susceptible and resistant TB, to find effective drugs for treatment of drug-resistant TB, to shorten therapy for latent TB infection and to reduce drug interactions in combination with antiretroviral therapy, a major issue in the treatment of HIV co-infected patients. This review will attempt to summarize the current recommendations for treatment of TB and then describe the most promising new antimicrobials with activity against MTB, focusing on the ones currently undergoing clinical trials.
据估计，全球三分之一的人口感染了结核分枝杆菌（MTB），2006年全球约有160万人死于结核病（TB），结核病如今仍是一个主要的公共卫生问题。在结核病的有效治疗方面已经取得了相当大的进展，特别是在国家结核病控制项目中采用了短程直接观察治疗法（DOTS），但尽管如此，目前可用的治疗方案仍不尽人意。所需的疗程较长，加上药物副作用严重以及由此导致的治疗依从性困难，都促使新出现的耐药问题日益严重。因此，迫切需要开发新的抗结核药物，特别是要为敏感结核病和耐药结核病提供有效的短程治疗方案，找到治疗耐药结核病的有效药物，缩短潜伏性结核感染的治疗时间，并减少与抗逆转录病毒疗法联合使用时的药物相互作用，这是治疗合并感染HIV患者时的一个主要问题。本综述将试图总结目前结核病治疗的建议，然后描述最有前景的对MTB有活性的新型抗菌药物，重点关注目前正在进行临床试验的药物。
