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治疗失败患者既往结核病治疗史的特征及其对获得性耐药结核病的影响

Characteristics of Previous Tuberculosis Treatment History in Patients with Treatment Failure and the Impact on Acquired Drug-Resistant Tuberculosis.

作者信息

Soedarsono Soedarsono, Mertaniasih Ni Made, Kusmiati Tutik, Permatasari Ariani, Ilahi Wiwik Kurnia, Anggraeni Amelia Tantri

机构信息

Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia.

Sub-Pulmonology Department of Internal Medicine, Faculty of Medicine, Hang Tuah University, Surabaya 60244, Indonesia.

出版信息

Antibiotics (Basel). 2023 Mar 16;12(3):598. doi: 10.3390/antibiotics12030598.

Abstract

Tuberculosis (TB) treatment failure is a health burden, as the patient remains a source of infection and may lead to the development of multi-drug resistance (MDR). Information from cases of treatment failure that develop into MDR, which is related to a history of previous TB treatment, in accordance with the pharmacokinetic aspect, is one important thing to prevent TB treatment failure and to prevent drug resistance. This was an observational descriptive study in an acquired MDR-TB patient who had a prior history of treatment failure. A structured questionnaire was used to collect information. The questionnaire consisted of a focus on the use of TB drug formulas during the treatment period, as well as when and how to take them. This study included 171 acquired MDR-TB patients from treatment failure cases. An amount of 64 patients received the separated TB drug, and 107 patients received the fixed dose combination (FDC) TB drug. An amount of 21 (32.8%) patients receiving separated TB drug and six (5.6%) patients receiving FDC TB drug took their drug in divided doses. In addition, three (4.7%) patients receiving separated TB drug and eight (7.5%) patients receiving FDC TB drug took their drug with food. An amount of 132 out of 171 (77.2%) patients had a history of incorrect treatment that developed into MDR-TB. Education on how to take the correct medication, both the separate version and the FDC TB drug, according to the pharmacokinetic aspect, is important before starting TB treatment.

摘要

结核病(TB)治疗失败是一项健康负担,因为患者仍是传染源,可能导致耐多药(MDR)的出现。根据药代动力学方面的情况,从发展为耐多药的治疗失败病例中获取与既往结核病治疗史相关的信息,对于预防结核病治疗失败和耐药性至关重要。这是一项针对有既往治疗失败史的获得性耐多药结核病患者的观察性描述性研究。采用结构化问卷收集信息。问卷重点关注治疗期间结核病药物配方的使用情况,以及服药时间和方式。本研究纳入了171例来自治疗失败病例的获得性耐多药结核病患者。其中64例患者接受了单独的结核病药物治疗,107例患者接受了固定剂量复合(FDC)结核病药物治疗。接受单独结核病药物治疗的患者中有21例(32.8%)分多次服药,接受FDC结核病药物治疗的患者中有6例(5.6%)分多次服药。此外,接受单独结核病药物治疗的患者中有3例(4.7%)与食物同服,接受FDC结核病药物治疗的患者中有8例(7.5%)与食物同服。171例患者中有132例(77.2%)有治疗不当史并发展为耐多药结核病。在开始结核病治疗前,根据药代动力学情况对如何正确服药(无论是单独剂型还是FDC结核病药物)进行教育很重要。

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