Grosset J H, Guelpa-Lauras C C, Bobin P, Brucker G, Cartel J L, Constant-Desportes M, Flageul B, Frédéric M, Guillaume J C, Millan J
Department de Bactériologie-Virologie, Faculté de Médecine Pitié-Salpêtrière, Paris, France.
Int J Lepr Other Mycobact Dis. 1989 Sep;57(3):607-14.
Among 39 strains of Mycobacterium leprae isolated from patients with multibacillary leprosy who relapsed after treatment with rifampin (RMP), 22 strains were resistant to RMP and 17 were susceptible. All of the RMP-resistant strains were recovered from patients who had been treated with more than 50 doses of RMP, usually given as monotherapy. RMP-susceptible strains were recovered from only six patients who had received more than 50 doses of RMP, and from 11 patients who had received no more than seven doses. The median time to relapse after the beginning of RMP therapy was 9 years (range 1-12 years) among the patients harboring RMP-resistant strains of M. leprae, and the median time to relapse after discontinuation of RMP treatment was 7 years (range 1-11 years) among the patients harboring RMP-susceptible strains. These data suggest that monotherapy with more than a few doses of RMP can be responsible for the emergence of RMP-resistant strains of M. leprae, thus emphasizing the need to employ RMP only in combination with other effective drugs in the chemotherapy of multibacillary leprosy.
在从接受利福平（RMP）治疗后复发的多菌型麻风病患者中分离出的39株麻风分枝杆菌菌株中，22株对RMP耐药，17株敏感。所有对RMP耐药的菌株均来自接受过50多剂RMP治疗的患者，通常为单药治疗。对RMP敏感的菌株仅从6例接受过50多剂RMP治疗的患者以及11例接受不超过7剂RMP治疗的患者中分离得到。在携带对RMP耐药的麻风分枝杆菌菌株的患者中，开始RMP治疗后复发的中位时间为9年（范围1 - 12年），而在携带对RMP敏感菌株的患者中，停用RMP治疗后复发的中位时间为7年（范围1 - 11年）。这些数据表明，使用几剂以上的RMP单药治疗可能会导致对RMP耐药的麻风分枝杆菌菌株出现，因此强调在多菌型麻风病化疗中仅将RMP与其他有效药物联合使用的必要性。
