Macnab M F, Bohmer P D, Seager J R
City Health Department, Cape Town.
S Afr Med J. 1994 Jun;84(6):325-8.
The subjective impression among clinicians that the use of Rifater was causing delayed sputum conversion and increased drug resistance was tested in a prospective study. Adults in the Cape Town municipal area with a first episode of pulmonary tuberculosis were treated either with Rifater or a regimen consisting of isoniazid, rifampicin, pyrazinamide and ethambutol. All patients who took the treatment as prescribed (67 Rifater, 39 the 4-drug regimen) converted to a negative sputum culture by the time 90 doses had been taken. The rates of inadequate compliance and of side-effects were similar in the two groups. Drug sensitivity testing of bacteria cultured from pre-treatment sputum specimens revealed an overall primary resistance rate of 4.84% in the population studied, sufficiently low to preclude any necessity for routine pre-treatment drug sensitivity testing.
临床医生中有这样一种主观印象，即使用卫非特会导致痰菌转阴延迟和耐药性增加，一项前瞻性研究对这一印象进行了验证。开普敦市区首次发作肺结核的成年人，要么接受卫非特治疗，要么接受由异烟肼、利福平、吡嗪酰胺和乙胺丁醇组成的治疗方案。所有按规定接受治疗的患者（67例使用卫非特，39例使用四联药物方案）在服用90剂药物时痰培养均转为阴性。两组的依从性不足率和副作用发生率相似。对治疗前痰标本培养的细菌进行药敏试验显示，在所研究的人群中总体初始耐药率为4.84%，低到没有必要进行常规治疗前药敏试验。
