Grosset J
Laboratoire central de bactériologie-virologie, groupe hospitalier Pitié-Salpêtrière, Paris.
Rev Prat. 1990 Mar 11;40(8):715-8.
To be fully effective, short-course chemotherapy for tuberculosis should take into account the slow growth rate, high oxygen requirement and high drug-resistant mutant emergence rate of Mycobacterium tuberculosis, as well as the type of the lesions observed and the specific activity of each antituberculous drug. Due to their unique sterilizing activities against bacilli that are not actively metabolizing, rifampicin and pyrazinamide are the key drugs for short-course chemotherapy. To prevent the selection of drug-resistant mutants and the occurrence of therapeutic failures, a combination of isoniazid, rifampicin, pyrazinamide and ethambutol should be given during the first two months of treatment. To kill persisting M. tuberculosis, and thus avoid posttreatment relapses, the isoniazid-rifampicin combination should be prescribed for à further four months.
为达到完全有效的治疗效果，结核病短程化疗应考虑结核分枝杆菌生长缓慢、需氧量高、耐药突变株出现率高的特点，以及所观察到的病变类型和每种抗结核药物的具体活性。利福平和吡嗪酰胺对非活跃代谢的杆菌具有独特的杀菌活性，因此是短程化疗的关键药物。为防止耐药突变株的产生和治疗失败的发生，治疗的前两个月应联合使用异烟肼、利福平、吡嗪酰胺和乙胺丁醇。为杀灭持续存在的结核分枝杆菌，从而避免治疗后复发，应再给予异烟肼-利福平联合治疗四个月。
