National Center for TB Control and Prevention, China Center for Disease Control and Prevention, Beijing, China.
Int J Tuberc Lung Dis. 2010 Jul;14(7):884-9.
To assess the availability of second-line drugs (SLDs) and the use of drug susceptibility testing (DST) results for the treatment of tuberculosis (TB) in China.
Cross-sectional survey in 4675 health care facilities, 1960 of which have a dedicated TB clinic, in 12 provinces in China.
More than 70% of TB clinics at the provincial and prefecture levels had at least one SLD available compared to 41.8% of facilities at the county/district level. The proportion of facilities at provincial, prefecture and county levels with any fluoroquinolone was respectively 74.1%, 64.9% and 34.5%. Sputum culture was performed at 6.0% of TB clinics at the county level, 37.5% at the prefecture and 59.3% at the provincial levels, while DST was performed only at the prefecture (28.6%) and provincial (44.4%) levels. Only 18% of the facilities that used SLDs for the treatment of multidrug-resistant TB (MDR-TB) based treatment regimens on DST results.
SLDs are widely available in China for the treatment of both TB and other infectious diseases. To prevent the development of Mycobacterium tuberculosis resistance to SLDs, the availability of SLDs should be limited and they should be used with caution in the treatment of MDR-TB.
评估中国二线药物（SLD）的可及性以及药物敏感性测试（DST）结果在结核病（TB）治疗中的应用。
在中国 12 个省份的 4675 家卫生保健机构（其中 1960 家设有专门的结核病诊所）进行横断面调查。
与县级/区级医疗机构的 41.8%相比，省级和地市级结核病诊所至少有 1 种 SLD 可供使用的比例超过 70%。省级、地市级和县级医疗机构中使用任何氟喹诺酮类药物的比例分别为 74.1%、64.9%和 34.5%。县级结核病诊所进行痰培养的比例为 6.0%，地市级为 37.5%，省级为 59.3%，而 DST 仅在地市级（28.6%）和省级（44.4%）进行。仅有 18%的医疗机构根据 DST 结果使用 SLD 治疗方案治疗耐多药结核病（MDR-TB）。
中国广泛提供 SLD 治疗结核病和其他传染病。为防止结核分枝杆菌对 SLD 产生耐药性，应限制 SLD 的可及性，并谨慎将其用于治疗 MDR-TB。
