Ramírez Lapausa Marta, Pascual Pareja José Francisco, Noguerado Asensio Arturo
Servicio de Medicina Interna, Hospital Universitario de Cantoblanco-La Paz, Madrid, España.
Med Clin (Barc). 2013 Oct 5;141(7):306-13. doi: 10.1016/j.medcli.2013.01.039. Epub 2013 Mar 26.
Drug-resistant tuberculosis is a globally emerging problem with a rising incidence. According to the WHO in 2008, 17% of strains of Mycobacterium tuberculosis, in untreated cases were resistant to at least one drug and 3.6% were resistant to rifampicin and isoniazid, which is called multidrug-resistant tuberculosis. The problem is greater in patients previously treated and in some countries, where rates of multidrug resistance reach 60%. Approximately 5% of multidrug-resistant tuberculosis patients are also resistant to any fluoroquinolone and at least one injectable drug, being called extensively drug-resistant tuberculosis. The treatment of these forms of tuberculosis requires the use of second-line drugs, which causes higher cost, higher toxicity and a longer duration of treatment. There is a need for new compounds with efficacy and safety profiles better than those currently used to treat these forms of tuberculosis. In the last decade different drugs have being reassessed and appeared, which are at different stages of development.
耐多药结核病是一个在全球范围内日益凸显的问题,其发病率不断上升。根据世界卫生组织2008年的数据,在未经治疗的病例中,17%的结核分枝杆菌菌株对至少一种药物耐药,3.6%对利福平和异烟肼耐药,这被称为耐多药结核病。在既往接受过治疗的患者以及一些国家,这一问题更为严重,耐多药率高达60%。大约5%的耐多药结核病患者还对任何氟喹诺酮类药物和至少一种注射用药物耐药,被称为广泛耐药结核病。治疗这些类型的结核病需要使用二线药物,这会导致更高的成本、更高的毒性和更长的治疗时间。需要有疗效和安全性优于目前用于治疗这些类型结核病药物的新化合物。在过去十年中,不同的药物一直在重新评估并出现,它们处于不同的研发阶段。