Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, 550 1st Avenue, New York, NY 10016, USA.
Expert Rev Anti Infect Ther. 2010 Jul;8(7):801-13. doi: 10.1586/eri.10.60.
Tools for effective TB control have been available for years. Case finding, active medications, case management and directly observed therapy are the foundations for the management of TB. The current TB epidemic, centered in resource-limited settings is fueled by the HIV-1 epidemic. Lack of ability to diagnose and treat drug-resistant TB has led to development of more extensive patterns of resistance. Among the currently available drugs, there is reason to hope that rifamycins paired with fluoroquinolones will lead to shorter treatment regimens for drug-susceptible TB. As the result of novel public-private collaborations and investments of resources, new drugs are being developed. These include TMC207, already shown to have activity early in the treatment of multidrug-resistant TB and others that are likely to be active against persistor organisms, and have the prospect to dramatically shorten treatment courses for active and latent TB. Given that these drugs have novel mechanisms of action, combinations have the prospect to be highly active even against multidrug-resistant organisms.
有效的结核病控制工具已经问世多年。发现病例、使用有效药物、病例管理和直接观察治疗是结核病管理的基础。目前以资源有限环境为中心的结核病流行是由 HIV-1 流行所推动的。由于缺乏诊断和治疗耐药结核病的能力，导致耐药性更加广泛。在目前可用的药物中，有理由希望利福霉素类药物与氟喹诺酮类药物联合使用，将导致对药物敏感的结核病的治疗方案缩短。由于新型公私合作关系和资源投入，正在开发新的药物。其中包括 TMC207，它在治疗耐多药结核病的早期已经显示出活性，以及其他可能对持久生物具有活性的药物，有望大大缩短活动性和潜伏性结核病的治疗疗程。鉴于这些药物具有新的作用机制，即使针对耐多药生物，联合用药也有可能具有很高的活性。
