Thadepalli H, Bach V T, Webb D W
Chest. 1979 May;75(5):569-70. doi: 10.1378/chest.75.5.569.
Anaerobic infections may coexist with tuberculosis, and can be mistaken for one another. The effect of therapy with antituberculosis chemotherapeutic agents against anaerobic bacteria (with the exception of rifampin) is unknown. We therefore examined the in vitro efficacy of certain commonly used antituberculosis agents (rifampin, isoniazid, and ethambutol) against 370 strains of anaerobic bacteria, including 86 isolates of Bacteroides fragilis. Rifampin at a concentration of 2 microgram/ml inhibited 91 percent of all anaerobic isolates. Both ethambutol and isoniazid were totally ineffective against any of the anaerobes tested, even at 64 microgram/ml. Therapy with rifampin in an unsuspected anaerobic infection can be misdiagnosed for tuberculosis. Therefore, when tuberculosis is suspected, isoniazid and ethambutol can be used and rifampin withheld until the acid-fast bacilli are demonstrated by additional diagnostic procedures, such as transtracheal aspiration.
厌氧菌感染可能与结核病并存，且两者可能相互误诊。抗结核化疗药物对厌氧菌（利福平除外）的治疗效果尚不清楚。因此，我们检测了某些常用抗结核药物（利福平、异烟肼和乙胺丁醇）对370株厌氧菌的体外疗效，其中包括86株脆弱拟杆菌分离株。浓度为2微克/毫升的利福平可抑制91%的厌氧菌分离株。乙胺丁醇和异烟肼对所有受试厌氧菌均完全无效，即使在浓度为64微克/毫升时也是如此。在未怀疑有厌氧菌感染的情况下使用利福平治疗可能会被误诊为结核病。因此，当怀疑患有结核病时，可使用异烟肼和乙胺丁醇，暂不使用利福平，直到通过额外的诊断程序（如经气管抽吸）证实存在抗酸杆菌。
