Iwanaga T, Yokota K, Kishikawa R, Ikeda T, Tsurutani H, Hirose T, Nishima S
Department of Pulmonary Medicine, National Minami-Fukuoka Chest Hospital, Fukuoka, Japan.
Kekkaku. 1997 Jan;72(1):9-13.
A 67-year-old [correction of 53] man with multidrug resistant tuberculosis (MDR-TB) had been persistently positive for acid-fast bacilli (AFB) both on sputum smear and also on culture with the Ogawa egg medium for 30 years since 1951. The case had been treated previously with isoniazid, rifampin, streptomycin, ethambutol, kanamycin, ethionamide, paraaminosalicylate and cycloserine; however, M. tuberculosis strains isolated from this patient acquired a high resistance to all of these agents. Then, a new regimen of chemotherapy, INH combined with ofloxacin (OFLX) and amoxicillin-clavulanic acid (AMPC/ CVA), was applied to the case. He was successfully treated with this regimen, and a marked decrease in the amount of AFB on smear as well as on culture was observed during the course of chemotherapy. No adverse effects were seen meanwhile. These data suggest that it is worth while to try a regimen containing AMPC/CVA and OFLX in the treatment of MDR-TB.
一名67岁[应为67岁而非53岁]的耐多药结核病（MDR-TB）男性患者，自1951年以来，其痰涂片和小川鸡蛋培养基培养的抗酸杆菌（AFB）持续呈阳性达30年。该病例此前接受过异烟肼、利福平、链霉素、乙胺丁醇、卡那霉素、乙硫异烟胺、对氨基水杨酸和环丝氨酸治疗；然而，从该患者分离出的结核分枝杆菌菌株对所有这些药物均产生了高度耐药性。随后，一种新的化疗方案，即异烟肼联合氧氟沙星（OFLX）和阿莫西林-克拉维酸（AMPC/CVA）应用于该病例。他通过该方案成功治愈，化疗过程中痰涂片和培养物中的AFB数量显著减少。同时未观察到不良反应。这些数据表明，在耐多药结核病治疗中尝试使用包含AMPC/CVA和OFLX的方案是值得的。
