Houston S, Fanning A
Department of Medicine, University of Alberta, Edmonton, Canada.
Drugs. 1994 Nov;48(5):689-708. doi: 10.2165/00003495-199448050-00004.
A recent resurgence of interest in tuberculosis as a global health problem has accompanied the resurgence of tuberculosis in both industrialised and developing countries. It has also been demonstrated recently that tuberculosis treatment and control is one of the most cost effective of all medical interventions. The human immunodeficiency virus (HIV) epidemic and increasing resistance to antituberculous drugs complicate our response to the problem of tuberculosis. Chemotherapy with currently available agents is highly effective, not only in pulmonary tuberculosis in adults, but also in extrapulmonary disease, and in disease in children and even patients with concomitant HIV infection. Short course chemotherapy and intermittent therapy are as effective as older regimens. Measures, including directly observed therapy, to maximise compliance with therapy, are of utmost importance. An efficient programme which assures compliance with effective antituberculosis chemotherapy should be a priority for health spending even in those countries with fewest resources.
随着结核病在工业化国家和发展中国家的再度流行,最近人们对结核病作为一个全球健康问题的兴趣再度高涨。最近还表明,结核病的治疗和控制是所有医疗干预措施中最具成本效益的措施之一。人类免疫缺陷病毒(HIV)的流行以及对抗结核药物耐药性的增加,使我们应对结核病问题变得更加复杂。使用现有药物进行化疗非常有效,不仅对成人肺结核有效,对肺外疾病、儿童疾病甚至合并HIV感染的患者也有效。短程化疗和间歇疗法与旧方案一样有效。包括直接观察治疗在内的措施对于最大限度地提高治疗依从性至关重要。即使在资源最少的国家,确保有效抗结核化疗依从性的高效项目也应成为卫生支出的优先事项。