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[抗结核药物不良反应的管理]

[Managing the adverse events of antitubercular agents].

作者信息

Perriot J, Chambonnet E, Eschalier A

机构信息

Dispensaire Émile-Roux, centre de lutte antituberculeux du Puy-de-Dôme 63, 11, rue Vaucanson, 63100 Clermont-Ferrand, France.

出版信息

Rev Mal Respir. 2011 Apr;28(4):542-55. doi: 10.1016/j.rmr.2010.10.034. Epub 2011 Mar 25.

Abstract

Tuberculosis, an infectious disease which is curable by following a course of antibiotics, remains a major public health issue on a global scale. A therapeutic strategy has been standardised which calls for the use of four antibiotics. These are generally well-tolerated but, individually and in combination, frequently have undesirable effects. Isoniazid may cause hepatic toxicity and an also be an asue of peripheral neuropathy. Rifampin is a strong hepatic enzyme inducer and can be responsible for severe immunoallergic reactions in the case of interrupted treatment. Pyrazinamide sometimes results in severe hepatotoxicity. Ethambutol can be responsible for severe ocular toxicity. Both older antituberculous medications and new generation antibiotic medications used for the treatment of resistant bacilli can also be the source of adverse events. The treatment of tuberculosis is standardised but the decision to treat it is inseparable from the evaluation of possible side effects which require assessment prior to the initiation of therapy and close monitoring during treatment which includes ensuring that patients are aware of and vigilant for potential problems.This work describes the adverse events of different antibiotic medications so that, on an individual basis they can be anticipated and appropriately managed.

摘要

结核病是一种通过服用一个疗程的抗生素即可治愈的传染病,但在全球范围内仍然是一个重大的公共卫生问题。一种治疗策略已经标准化,即使用四种抗生素。这些抗生素一般耐受性良好,但无论是单独使用还是联合使用,都经常会产生不良影响。异烟肼可能会导致肝毒性,还可能引发周围神经病变。利福平是一种强效肝酶诱导剂,在治疗中断时可能会引发严重的免疫过敏反应。吡嗪酰胺有时会导致严重的肝毒性。乙胺丁醇可能会导致严重的眼部毒性。用于治疗耐药杆菌的老一代抗结核药物和新一代抗生素药物也都可能是不良事件的来源。结核病的治疗是标准化的,但治疗决策与对可能的副作用的评估密不可分,这需要在治疗开始前进行评估,并在治疗期间进行密切监测,包括确保患者了解并警惕潜在问题。这项工作描述了不同抗生素药物的不良事件,以便能够针对个体情况对其进行预测并妥善处理。

相似文献

1
[Managing the adverse events of antitubercular agents].[抗结核药物不良反应的管理]
Rev Mal Respir. 2011 Apr;28(4):542-55. doi: 10.1016/j.rmr.2010.10.034. Epub 2011 Mar 25.
3
[Therapy of tuberculosis in the adult].[成人肺结核的治疗]
Med Klin (Munich). 1995 Apr 15;90(4):229-30.
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[Antitubercular chemotherapy].[抗结核化疗]
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