Goble M
National Jewish Center for Immunology and Respiratory Medicine, Denver, CO 80206.
Semin Respir Infect. 1986 Dec;1(4):220-9.
Management of drug-resistant tuberculosis (TB) is challenging. In areas with high prevalence of drug-resistant TB, we recommend starting all patients with active TB on the standard four or five drug regimens. For patients with acquired drug resistance due to prior inadequate therapy, we advocate thorough evaluation of history and drug susceptibility followed by individualized regimens of at least three drugs. Drugs are most effective if the patient has never received them before and if the patient's tubercle bacilli are susceptible to them in vitro. Retreatment regimens are of long duration and often there are adverse drug reactions. These factors must be put into perspective because options for alternate therapy may be limited. Compliance must be assured.
耐多药结核病的管理具有挑战性。在耐多药结核病高发地区，我们建议所有活动性结核病患者开始采用标准的四联或五联药物治疗方案。对于因先前治疗不充分而获得性耐药的患者，我们主张全面评估病史和药物敏感性，然后采用至少三种药物的个体化治疗方案。如果患者以前从未使用过这些药物，并且患者的结核杆菌在体外对这些药物敏感，那么这些药物的效果最佳。复治方案疗程长，且常常会出现药物不良反应。必须正确看待这些因素，因为替代治疗的选择可能有限。必须确保患者的依从性。
