Kozlova N V, Dzhumaev B, Stepanian E S, Kaminskaia G O
Antibiotiki. 1976 Jul;21(7):650-4.
Data on the experimental and clinical study of capreomycin in the treatment of tuberculosis are presented. It was shown that capreomycin had low activity with respect to the sensitive strain of Mycobacterium tuberculosis H37 Rv in vitro and the respective infection caused by it in mice. The activity of capreomycin in vitro with respect to streptomycin resistant strains was the same as that with respect to the sensitive strains, while in vivo it increased 3 times. Capreomycin showed a tendency to decreasing its activity with respect to strains highely resistant to canamycin only in vitro. The effect of capreomycin on tuberculosis infection caused by strains resistant to different concentrations of canamycin was the same as that on tuberculosis infection caused by sensitive strains. Cross resistance between florimycin (viomycin) and capreomycin was shown. Clinical trails of capreomycin revealed its moderate therapeutic efficiency, relatively low toxicity and an allergenizing effect on the host. Transient ventibulopatia without pronounced signs of ototoxic action was observed. The nephrotoxic effect was moderate and transient. It was observed predominantly at the peak of the allergic reactions to the antitubercle drugs. The data obtained during the study allow recommendation of capreomycin use in clinics as reserve drug when the causative agent is not resistant to florimycin. The drug should be used under regular control of the blood picture, electrolyte metabolism, state of the kidneys, auditory and vestibular apparatus.
本文介绍了卷曲霉素治疗结核病的实验和临床研究数据。结果表明,卷曲霉素在体外对结核分枝杆菌H37 Rv敏感菌株及其在小鼠体内引起的相应感染活性较低。卷曲霉素在体外对链霉素耐药菌株的活性与对敏感菌株的活性相同,而在体内则增加了3倍。仅在体外,卷曲霉素对卡那霉素高度耐药菌株的活性有降低趋势。卷曲霉素对不同浓度卡那霉素耐药菌株引起的结核感染的作用与对敏感菌株引起的结核感染的作用相同。已表明紫霉素(紫霉素)与卷曲霉素之间存在交叉耐药性。卷曲霉素的临床试验显示其治疗效果中等,毒性相对较低,对宿主有过敏作用。观察到短暂的前庭病,无明显耳毒性作用迹象。肾毒性作用中等且短暂。主要在对抗结核药物过敏反应的高峰期观察到。研究期间获得的数据允许在病原体对紫霉素不耐药时,推荐卷曲霉素作为储备药物在临床上使用。该药物应在定期监测血常规、电解质代谢、肾脏、听觉和前庭器官状态的情况下使用。