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结核病治疗的新药。

New drugs for tuberculosis treatment.

机构信息

Servei de Medicina Interna i Malalties Infeccioses, Hospital del Mar, Barcelona, Spain.

出版信息

Enferm Infecc Microbiol Clin. 2011 Mar;29 Suppl 1:47-56. doi: 10.1016/S0213-005X(11)70018-0.

Abstract

Available data on anti-tuberculosis drug research reveal different properties of the agents and provoke speculation about future directions. Higher doses of the rifamycins are promising and are currently being evaluated in regimens of shorter duration that the isoniazid plus rifampin-based, six-to-nine month-course therapy. Moxifloxacin and gatifloxacin might shorten tuberculosis treatment as well, possibly in combination with rifapentine, while SQ109 could enhance the activity of rifampin-containing regimens. On the other hand, co-administration of moxifloxacin and PA-824 could be active against latent tuberculosis, whereas linezolid, PA-824 and TMC207 are candidates for a rifampin-free regimen in multidrug-resistant and extensively-resistant tuberculosis. Unfortunately, shorter than existent treatment regimens based on the new agents discussed here are likely to take at least another decade to be fully developed and implemented in clinical practice.

摘要

现有的抗结核药物研究数据显示出这些药物具有不同的特性,这引发了人们对未来发展方向的猜测。更高剂量的利福霉素类药物具有很大的应用前景,目前正在评估将其用于更短疗程的方案中,取代以异烟肼和利福平为基础的 6-9 个月疗程的治疗方案。莫西沙星和加替沙星也可能缩短结核病的治疗时间,可能与利福喷丁联合使用,而 SQ109 则可以增强包含利福平的方案的活性。另一方面,莫西沙星和 PA-824 的联合应用可能对抗潜伏性结核病具有活性,而利奈唑胺、PA-824 和 TMC207 则可能成为耐多药和广泛耐药结核病无利福平治疗方案的候选药物。不幸的是,比现有基于新药物的治疗方案更短的疗程可能需要至少十年的时间才能完全开发并应用于临床实践。

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