Tsukamura M
National Chubu Hospital, Aichi, Japan.
Am Rev Respir Dis. 1988 Jan;137(1):144-8. doi: 10.1164/ajrccm/137.1.144.
Successful chemotherapy of pulmonary disease caused by Mycobacterium avium complex by antituberculosis drugs has been reported by a number of investigators. However, no certain evidence of the efficacy has yet been demonstrated in a controlled clinical trial. The present study has approached this problem in 2 ways: serial analysis of minimal inhibitory concentrations (MIC) during treatment and correlation of response to therapy with initial MIC. It was observed that after administration of antituberculosis drugs (rifampin, isoniazid, kanamycin, enviomycin, and minocycline), MIC values for the M. avium complex strain increased significantly. This change may be considered a result of suppression of relatively susceptible bacteria and as evidence of the efficacy of drugs. Furthermore, a correlation between the MIC values determined before chemotherapy with the conversion of sputum to negative was shown. The M. avium complex strains varied markedly in their susceptibility to antituberculosis drugs, and these susceptibilities were correlated with the chemotherapeutic effect. The fate of patients seemed to be greatly influenced by the susceptibilities of the strains that caused infection.
许多研究者报告了抗结核药物成功治疗鸟分枝杆菌复合群引起的肺部疾病。然而，在对照临床试验中尚未证实其疗效的确切证据。本研究通过两种方式解决了这个问题：治疗期间对最低抑菌浓度（MIC）进行系列分析，以及将治疗反应与初始MIC进行关联。观察到给予抗结核药物（利福平、异烟肼、卡那霉素、恩维霉素和米诺环素）后，鸟分枝杆菌复合群菌株的MIC值显著增加。这种变化可被视为相对敏感细菌受到抑制的结果，也是药物疗效的证据。此外，化疗前测定的MIC值与痰菌转阴之间存在相关性。鸟分枝杆菌复合群菌株对抗结核药物的敏感性差异显著，这些敏感性与化疗效果相关。患者的预后似乎受引起感染的菌株敏感性的极大影响。
