Sotgiu Giovanni, Centis Rosella, D'ambrosio Lia, Migliori Giovanni Battista
Clinical Epidemiology and Medical Statistics Unit, Department of Biomedical Sciences, University of Sassari, Research, Medical Education and Professional Development Unit, AOU Sassari 07100, Italy.
World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute, Tradate 21049, Italy.
Cold Spring Harb Perspect Med. 2015 Jan 8;5(5):a017822. doi: 10.1101/cshperspect.a017822.
Tuberculosis is an airborne infectious disease treated with combination therapeutic regimens. Adherence to long-term antituberculosis therapy is crucial for maintaining adequate blood drug level. The emergence and spread of drug-resistant Mycobacterium tuberculosis strains are mainly favored by the inadequate medical management of the patients. The therapeutic approach for drug-resistant tuberculosis is cumbersome, because of the poor, expensive, less-effective, and toxic alternatives to the first-line drugs. New antituberculosis drugs (bedaquiline and delamanid) have been recently approved by the health authorities, but they cannot represent the definitive solution to the clinical management of drug-resistant tuberculosis forms, particularly in intermediate economy settings where the prevalence of drug resistance is high (China, India, and former Soviet Union countries). New research and development activities are urgently needed. Public health policies are required to preserve the new and old therapeutic options.
结核病是一种通过联合治疗方案进行治疗的空气传播传染病。坚持长期抗结核治疗对于维持足够的血药浓度至关重要。耐药结核分枝杆菌菌株的出现和传播主要是由于对患者的医疗管理不足所致。耐药结核病的治疗方法很繁琐,因为一线药物的替代药物效果不佳、价格昂贵、疗效较差且有毒性。新型抗结核药物(贝达喹啉和地拉曼德)最近已获卫生当局批准,但它们并不能代表耐药结核病临床管理的最终解决方案,尤其是在耐药率较高的中等经济水平地区(中国、印度和前苏联国家)。迫切需要开展新的研发活动。需要制定公共卫生政策来保留新旧治疗方案。