关键词: 结核,肺, 结核,抗多种药物性, 临床方案, 治疗结果, 综述文献(主题)

Abstract:

The treatment duration is a critical determinant for the cure of patients with tuberculosis. The long duration of treatment of drug-susceptible pulmonary tuberculosis is associated with nonadherence and loss to follow up, and the treatment success rate of multidrug-resistant pulmonary tuberculosis is lower with longer regimens. The current standard six-month regimen for drug-susceptible pulmonary tuberculosis are highly effective, however, challenges such as increasing drug resistance, poor treatment adherence, drug interactions, adverse effects or pharmacokinetic variability may result in suboptimal treatment outcomes. The development of safe and effective tuberculosis drug regimens that could shorten the time to sputum culture conversion, improve cure and treatment completion rates, reduce morbidity, mortality and relapse is critical. A shorter effective regimen for treating tuberculosis would be a boon for both patients and healthcare providers which could improve rates of adherence, reduce rates of adverse events, and lower costs. There were many methods to shorten the regimen course for the treatment of drug-susceptible pulmonary tuberculosis, e.g. a 4-month regimen of 2H-R-Z(E)/2H-R (isoniazid, H; rifampin, R; pyrazinamide, Z; ethambutol, E); a 4-month regimen of 2R₇-H₇-Z₇-E₇-Mfx₇/2R₇-H₇-Mfx₇ (moxifloxacin, Mfx); a 4-month regimen which modifies the standard 6-month regimen by replacing H or E with standard dose of Mfx. For drug-resistant tuberculosis, there were new treatment regimens like adding fluoroquinolones into the standard regimen; new regimens with new anti-tuberculosis drugs such as bedaquiline, delamanid or pretomanid; using high doses of old drugs and replacing injection drugs with all oral administration drugs. Thereby a review has been developed on the above-mentioned shorter course regimens for the treatment of drug-susceptible pulmonary tuberculosis and drug-resistant tuberculosis.

Key words: Tuberculosis, pulmonary, Tuberculosis, multidrug-resistant, Clinical protocols, Treatment outcome, Review literature as topic