Radal M, Jonville-Bera A P, Van-Egroo C, Carré P, Lemarié E, Autret E
Service de Pharmacologie Clinique et Centre Régional de Pharmacovigilance et de Renseignement sur le Médicament, Hôpital Bretonneau, Tours.
Rev Mal Respir. 1998 Jun;15(3):305-6.
We report 3 cases of rash after the first dose of antituberculosis polytherapy, thus raising questions concerning the procedures to be followed.
Three patients developed a pruritic rash 1 hour after the first dose of isoniazide, rifampicine, pyrazinamide and ethambutol given simultaneously. The eruption did not recur after readministration of isoniazide and rifampicine successively. Pyrazinamide, which was readministered last (at the full dose in one case and at progressive doses in the two others), induced a recurrence in two of them. Pyrazinamide was definitively withdrawn in one patient with recurrence and slower pyrazinamide readministration allowed continuation of treatment in the other two patients.
Since pyrazinamide appeared to be responsible for rash following the first administration of antituberculosis polytherapy, a protocol for readministration of the 4 drugs is suggested. If the responsibility of pyrazinamide is confirmed it should be readministered very slowly.
我们报告了3例在首次服用抗结核联合疗法药物后出现皮疹的病例，从而引发了关于后续应遵循程序的问题。
3例患者在同时首次服用异烟肼、利福平、吡嗪酰胺和乙胺丁醇1小时后出现瘙痒性皮疹。在先后再次服用异烟肼和利福平后皮疹未复发。最后再次服用的吡嗪酰胺（1例为全剂量，另外2例为递增剂量）导致其中2例皮疹复发。1例复发患者最终停用吡嗪酰胺，另外2例患者通过更缓慢地再次服用吡嗪酰胺得以继续治疗。
由于吡嗪酰胺似乎是首次服用抗结核联合疗法药物后出现皮疹的原因，建议制定4种药物再次服用的方案。如果吡嗪酰胺的责任得到确认，应非常缓慢地再次服用。
