Am Rev Respir Dis. 1986 Aug;134(2):355-63. doi: 10.1164/arrd.1986.134.2.355.
Treatment of tuberculosis: A 6-month regimen consisting of isoniazid, rifampin, and pyrazinamide given for 2 months followed by isoniazid and rifampin for 4 months is effective treatment in patients with fully susceptible organisms who comply with the treatment regimen. It may be advisable to include ethambutol in the initial phase when isoniazid resistance is suspected. A 9-month regimen consisting of isoniazid and rifampin is also highly successful. The need for an additional drug in the initial phase is not certain unless isoniazid resistance is suspected, in which case ethambutol should be included until susceptibility tests have been reported. In the presence of documented resistance to isoniazid, rifampin and ethambutol, perhaps supplemented initially by pyrazinamide, should be given for minimum of 12 months. Children should be treated in essentially the same ways as adults using appropriately adjusted doses of the drugs. However, consideration must be given to the important differences in the approach to management in children. Extrapulmonary tuberculosis should be managed according to the principles and with the drug regimens outlined to pulmonary tuberculosis. The major determinant of the outcome of treatment is patient compliance. Careful attention should be paid to measures designed to foster compliance and to ensure that patients take the drugs as prescribed. Treatment of tuberculous infection: Preventive therapy with isoniazid given for 6 to 12 months is effective in decreasing the risk of future tuberculosis. (ABSTRACT TRUNCATED AT 250 WORDS)
对于结核菌完全敏感且能遵守治疗方案的患者,一种为期6个月的治疗方案有效,即前2个月使用异烟肼、利福平及吡嗪酰胺,后4个月使用异烟肼和利福平。当怀疑有异烟肼耐药时,初始阶段可加用乙胺丁醇。一种为期9个月的异烟肼和利福平治疗方案也非常成功。除非怀疑有异烟肼耐药,否则初始阶段是否需要加用其他药物并不确定,若怀疑耐药,则应加用乙胺丁醇直至药敏试验结果报告出来。若已证实对异烟肼、利福平和乙胺丁醇耐药,初始阶段可能需加用吡嗪酰胺,治疗至少持续12个月。儿童的治疗方式与成人基本相同,但需使用适当调整剂量的药物。不过,必须考虑儿童治疗管理方法上的重要差异。肺外结核病应根据治疗肺结核的原则和用药方案进行管理。治疗结果的主要决定因素是患者的依从性。应密切关注旨在提高依从性的措施,确保患者按规定服药。结核感染的治疗:使用异烟肼进行6至12个月的预防性治疗可有效降低未来患结核病的风险。(摘要截选至250字)