Snider D E, Zierski M, Graczyk J, Bek E, Farer L S
Eur J Respir Dis. 1986 Jan;68(1):12-8.
During the past decade, six short-course (6-month) chemotherapy regimens were studied in which drugs were given daily and intermittently. Four regimens containing isoniazid, rifampin, and ethambutol caused little toxicity but yielded relapse rates (8-21%) which were unacceptably high. The safety of giving rifampin (450 or 600 mg) twice weekly was confirmed, however, and there was evidence that daily therapy during the 4-month continuation phase was no more effective than twice weekly isoniazid and rifampin. Once weekly therapy during the continuation phase was clearly inadequate. The use of four drugs (isoniazid, rifampin, pyrazinamide, and streptomycin) given daily during the initial 2 months of therapy followed by 4 months of twice weekly isoniazid and rifampin resulted in a nearly 100% cure rate. However, this regimen was not well tolerated by patients. Deleting streptomycin improved the tolerability of the regimen but appears to have slightly increased the frequency of treatment failure and relapse. A suggested model for choosing treatment regimens is presented.
在过去十年中，对六种短程（6个月）化疗方案进行了研究，这些方案中药物每日或间歇给药。四种含异烟肼、利福平及乙胺丁醇的方案毒性较小，但复发率（8%-21%）高得令人无法接受。不过，已证实利福平（450或600毫克）每周两次给药的安全性，且有证据表明，在4个月的继续治疗阶段每日治疗并不比异烟肼和利福平每周两次治疗更有效。继续治疗阶段每周一次治疗显然不足。在治疗的最初2个月每日使用四种药物（异烟肼、利福平、吡嗪酰胺和链霉素），随后4个月每周两次使用异烟肼和利福平，治愈率接近100%。然而，该方案患者耐受性不佳。去掉链霉素提高了方案的耐受性，但似乎略微增加了治疗失败和复发的频率。本文提出了一个选择治疗方案的建议模型。
