Jouveshomme S, Dautzenberg B
Service de Pneumologie et Réanimation Respiratoire, Groupe Hospitalier Pitié-Salpêtrière, Paris.
Rev Mal Respir. 1997 Dec;14 Suppl 5:S88-104.
Treatment of tuberculosis has three major goals: healing the patient, preventing selection of resistant strains and control transmission of tuberculosis. A 6 month regimen consisting of isoniazid, rifampin with addition of pyrazinamide for 2 months is the preferred treatment for pulmonary and extra-pulmonary tuberculosis. If resistance to isoniazid is suspected, ethambutol should be added until drug susceptibility studies become available. This treatment is effective in both HIV infected and uniinfected persons. Treatment failure is mostly related to lack of patient adherence to the drug regimen and to multidrug-resistant tuberculosis. The treatment of multidrug-resistant tuberculosis requires second line drugs which are less effective and poorly tolerated. Prevention of resistant tuberculosis needs adequate treatment of each case of tuberculosis and improving of the patient compliance.
治愈患者、防止耐药菌株的产生以及控制结核病的传播。由异烟肼、利福平组成的6个月疗程，并加用吡嗪酰胺2个月，是治疗肺结核和肺外结核的首选方案。如果怀疑对异烟肼耐药，应加用乙胺丁醇，直至获得药敏试验结果。这种治疗方法对感染和未感染HIV的患者均有效。治疗失败主要与患者未坚持用药方案以及耐多药结核病有关。耐多药结核病的治疗需要使用二线药物，这些药物疗效较差且耐受性不佳。预防耐药结核病需要对每一例结核病患者进行充分治疗，并提高患者的依从性。
