Dutt A K, Moers D, Stead W W
Ann Intern Med. 1986 Jan;104(1):7-12. doi: 10.7326/0003-4819-104-1-7.
Short-course chemotherapy with isoniazid and rifampin is well established for pulmonary tuberculosis but not yet for extrapulmonary disease. We report our 9-year experience with short-course chemotherapy in treating 350 patients; 402 extrapulmonary sites were involved. Therapy was largely self-administered with careful monitoring by local public health nurses. Administration of drugs was directly supervised in less than 2% of patients. Short-course chemotherapy with isoniazid and rifampin for 9 months was successful in 95% of patients, equivalent to conventional therapy with two to three drugs for 18 to 24 months. It was found that early drainage and complete debridement of necrotic material in bone lesions enhances healing. Short-course chemotherapy has excellent patient acceptance, short duration, fewer doses, and modest toxicity. Our largely twice-weekly regimen has the additional advantages of reduced cost, fewer doses, and ease of supervision when needed.
异烟肼和利福平的短程化疗对肺结核已确立了疗效，但对肺外疾病尚未如此。我们报告了9年来采用短程化疗治疗350例患者的经验；共累及402个肺外部位。治疗大多由患者自行进行，并由当地公共卫生护士仔细监测。不到2%的患者接受直接督导服药。异烟肼和利福平9个月的短程化疗在95%的患者中取得成功，等同于使用两到三种药物进行18至24个月的传统疗法。研究发现，早期引流和彻底清除骨病变中的坏死物质可促进愈合。短程化疗患者接受度高、疗程短、服药次数少且毒性适中。我们基本为每周两次的治疗方案还有成本降低、服药次数减少以及必要时便于督导的额外优势。
