Chinese Journal of Antituberculosis ›› 2021, Vol. 43 ›› Issue (9): 859-866.doi: 10.3969/j.issn.1000-6621.2021.09.002
• Guideline·Standard·Consensus • Previous Articles Next Articles
Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Chinese Antituberculosis Association, Editorial Board of Chinese Journal of Antituberculosis
Received:
2021-07-28
Online:
2021-09-10
Published:
2021-09-07
Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Chinese Antituberculosis Association, Editorial Board of Chinese Journal of Antituberculosis. Chinese expert consensus on the all-oral treatment of drug-resistant pulmonary tuberculosis (2021 Edition)[J]. Chinese Journal of Antituberculosis, 2021, 43(9): 859-866. doi: 10.3969/j.issn.1000-6621.2021.09.002
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药品 | 使用剂量 | ||
---|---|---|---|
体质量<45kg | 体质量46~55kg | 体质量>55kg | |
左氧氟沙星 | 500mg,1 次/d | 600mg,1 次/d | 600mg,1 次/d |
莫西沙星 | |||
普通剂量 | 400mg,1 次/d | 400mg,1 次/d | 400mg,1 次/d |
高剂量(短程方案推荐) | 600mg,1 次/d | 600mg,1 次/d | 800mg,1 次/d |
贝达喹啉 | 前2周内400mg,1 次/d;2周后200mg,每周3次 | ||
利奈唑胺 | |||
普通剂量 | 600mg,1 次/d | 600mg,1 次/d | 600mg,1 次/d |
高剂量 | 600mg,2 次/d | 600mg,2 次/d | 600mg,2 次/d |
氯法齐明 | |||
普通剂量 | 100mg,1 次/d | 100mg,1 次/d | 100mg,1 次/d |
高剂量 | 200mg,1 次/d | 200mg,1 次/d | 200mg,1 次/d |
环丝氨酸 | 0.25g,2 次/d | 0.25g,2 次/d或3 次/d | 0.25g,3 次/d |
乙胺丁醇 | 750mg,1 次/d | 750mg,1 次/d | 750mg,1 次/d |
德拉马尼 | 100mg,2 次/d | 100mg,2 次/d | 100mg,2 次/d |
吡嗪酰胺 | 500mg,2 次/d | 500mg,2 次/d | 500mg,3 次/d |
丙硫异烟胺 | 200mg,2 次/d | 200mg,3 次/d | 200mg,3 次/d |
对氨基水杨酸 | 4g,2次/d | 4g,2 次/d | 4g,2 次/d |
[1] | World Health Organization. WHO consolidated guidelines on drug-resistant tuberculosis treatment. Geneva: World Health Organization, 2019. |
[2] | World Health Organization. Global tuberculosis report 2020. Geneva: World Health Organization, 2020. |
[3] | World Health Organization. WHO consolidated guidelines on drug-resistant tuberculosis treatment. Geneva: World Health Organization, 2020. |
[4] | 肖和平. 耐药结核病化学治疗指南(2019年). 北京: 人民卫生出版社, 2019. |
[5] |
Fregonese F, Ahuja SD, Akkerman OW, et al. Comparison of different treatments for isoniazid-resistant tuberculosis: an individual patient data meta-analysis. Lancet Respir Med, 2018, 6(4):265-275. doi: 10.1016/S2213-2600(18)30078-X.
doi: 10.1016/S2213-2600(18)30078-X URL |
[6] |
Van Deun A, Maug AK, Salim MA, et al. Short, highly effective, and inexpensive standardized treatment of multidrug-resistant tuberculosis. Am J Respir Crit Care Med, 2010, 182(5):684-692. doi: 10.1164/rccm.201001-0077OC.
doi: 10.1164/rccm.201001-0077OC URL |
[7] |
Aung KJ, Van Deun A, Declercq E, et al. Successful ‘9-month Bangladesh regimen’ for multidrug-resistant tuberculosis among over 500 consecutive patients. Int J Tuberc Lung Dis, 2014, 18(10):1180-1187. doi: 10.5588/ijtld.14.0100.
doi: 10.5588/ijtld.14.0100 pmid: 25216831 |
[8] |
Piubello A, Harouna SH, Souleymane MB, et al. High cure rate with standardised short-course multidrug-resistant tuberculosis treatment in Niger: no relapses. Int J Tuberc Lung Dis, 2014, 18(10):1188-1194. doi: 10.5588/ijtld.13.0075.
doi: 10.5588/ijtld.13.0075 pmid: 25216832 |
[9] |
Kuaban C, Noeske J, Rieder HL, et al. High effectiveness of a 12-month regimen for MDR-TB patients in Cameroon. Int J Tuberc Lung Dis, 2015, 19(5):517-524. doi: 10.5588/ijtld.14.0535.
doi: 10.5588/ijtld.14.0535 pmid: 25868018 |
[10] | World Health Organization. WHO treatment guidelines for drug-resistant tuberculosis, 2016 update. Geneva: World Health Organization, 2016. |
[11] |
Nunn AJ, Phillips PPJ, Meredith SK, et al. A Trial of a Shorter Regimen for Rifampin-Resistant Tuberculosis. N Engl J Med, 2019, 380(13):1201-1213. doi: 10.1056/NEJMoa1811867.
doi: 10.1056/NEJMoa1811867 URL |
[12] |
Schwœbel V, Trébucq A, Kashongwe Z, et al. Outcomes of a nine-month regimen for rifampicin-resistant tuberculosis up to 24 months after treatment completion in nine African countries. EClinicalMedicine, 2020, 20:100268. doi: 10.1016/j.eclinm.2020.100268.
doi: 10.1016/j.eclinm.2020.100268 pmid: 32300732 |
[13] |
Abidi S, Achar J, Assao Neino MM, et al. Standardised shorter regimens versus individualised longer regimens for rifampin- or multidrug-resistant tuberculosis. Eur Respir J, 2020, 55(3):1901467. doi: 10.1183/13993003.01467-2019.
doi: 10.1183/13993003.01467-2019 URL |
[14] |
Bouton TC, de Vos M, Ragan EJ, et al. Switching to bedaquiline for treatment of rifampicin-resistant tuberculosis in South Africa: A retrospective cohort analysis. PLoS One, 2019, 14(10):e0223308. doi: 10.1371/journal.pone.0223308.
doi: 10.1371/journal.pone.0223308 URL |
[15] |
Tack I, Dumicho A, Ohler L, et al. Safety and effectiveness of an all-oral, bedaquiline-based, shorter treatment regimen for rifampicin-resistant tuberculosis in high HIV burden rural South Africa: a retrospective cohort analysis. Clin Infect Dis, 2020: ciaa1894. doi: 10.1093/cid/ciaa1894.
doi: 10.1093/cid/ciaa1894 |
[16] | World Health Organization. WHO consolidated guidelines on tuberculosis: module 4: treatment: drug-resistant tuberculosis treatment: online annexes. Geneva:World Health Organization, 2020. https://www.who.int/publications/i/item/9789240007048 |
[17] | World Health Organization. Rapid Communication: Key changes to the treatment of drug-resistant tuberculosis. Geneva: World Health Organization, 2018. |
[18] |
中华医学会结核病学分会. 中国耐多药和利福平耐药结核病治疗专家共识(2019年版). 中华结核和呼吸杂志, 2019, 42(10):733-749. doi: 10.3760/cma.j.issn.1001-0939.2019.10.006.
doi: 10.3760/cma.j.issn.1001-0939.2019.10.006 |
[19] |
Collaborative Group for the Meta-Analysis of Individual Patient Data in MDR-TB treatment-2017, Ahmad N, Ahuja SD, et al. Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis. Lancet, 2018, 392(10150):821-834. doi: 10.1016/S0140-6736(18)31644-1.
doi: 10.1016/S0140-6736(18)31644-1 URL |
[20] |
Lan Z, Ahmad N, Baghaei P, et al. Drug-associated adverse events in the treatment of multidrug-resistant tuberculosis: an individual patient data meta-analysis. Lancet Respir Med, 2020, 8(4):383-394. doi: 10.1016/S2213-2600(20)30047-3.
doi: 10.1016/S2213-2600(20)30047-3 URL |
[21] |
Zhao Y, Fox T, Manning K, et al. Improved Treatment Outcomes With Bedaquiline When Substituted for Second-line Injectable Agents in Multidrug-resistant Tuberculosis: A Retrospective Cohort Study. Clin Infect Dis, 2019, 68(9):1522-1529. doi: 10.1093/cid/ciy727.
doi: 10.1093/cid/ciy727 URL |
[22] |
Padayatchi N, Bionghi N, Osman F, et al. Treatment outcomes in patients with drug-resistant TB-HIV co-infection treated with bedaquiline and linezolid. Int J Tuberc Lung Dis, 2020, 24(10):1024-1031. doi: 10.5588/ijtld.20.0048.
doi: 10.5588/ijtld.20.0048 pmid: 33126934 |
[23] | World Health Organization. Meeting report of the WHO expert consultation on the definition of extensively drug-resis-tant tuberculosis, 27-29 October 2020. Geneva: World Health Organization, 2021. |
[24] |
Das M, Dalal A, Laxmeshwar C, et al. One step forward: Successful end-of-treatment outcomes of drug-resistant TB patients who received concomitant bedaquiline and delamanid in Mumbai, India. Clin Infect Dis, 2020: ciaa1577. doi: 10.1093/cid/ciaa1577.
doi: 10.1093/cid/ciaa1577 |
[25] |
中华医学会结核病学分会. 抗结核药物性肝损伤诊治指南(2019年版). 中华结核和呼吸杂志, 2019, 42(5):343-356. doi: 10.3760/cma.j.issn.1001-0939.2019.05.007.
doi: 10.3760/cma.j.issn.1001-0939.2019.05.007 |
[26] |
《中国防痨杂志》编委会, 中国医疗保健国际交流促进会结核病防治分会全国耐药结核病协作组. 耐药结核病化疗过程中药品不良反应处理的专家共识. 中国防痨杂志, 2019, 41(6):591-603. doi: 10.3969/j.issn.1000-6621.2019.06.003.
doi: 10.3969/j.issn.1000-6621.2019.06.003 |
[27] |
Nimmo C, Naidoo K, O’Donnell M.. Treatment of Highly Drug-Resistant Pulmonary Tuberculosis. N Engl J Med, 2020, 382(24):2376. doi: 10.1056/NEJMc2009939.
doi: 10.1056/NEJMc2009939 URL |
[28] |
Souleymane MB, Piubello A, Lawan IM, et al. High rifampicin-resistant TB cure rates and prevention of severe ototoxicity after replacing the injectable by linezolid in early stage of hearing loss. Eur Respir J, 2021, 57(1):2002250. doi: 10.1183/13993003.02250-2020.
doi: 10.1183/13993003.02250-2020 URL |
[29] |
Avaliani T, Sereda Y, Davtyan H, et al. Effectiveness and safety of fully oral modified shorter treatment regimen for multidrug-resistant tuberculosis in Georgia, 2019-2020. Monaldi Arch Chest Dis, 2021, 91(1). doi: 10.4081/monaldi.2021.1679.
doi: 10.4081/monaldi.2021.1679 |
[30] |
Das M, Mamnoon F, Mansoor H, et al. New TB drugs for the treatment of children and adolescents with rifampicin-resistant TB in Mumbai, India. Int J Tuberc Lung Dis, 2020, 24(12):1265-1271. doi: 10.5588/ijtld.20.0165.
doi: 10.5588/ijtld.20.0165 pmid: 33317670 |
[31] |
Mohr-Holland E, Reuter A, Furin J, et al. Injectable-free regimens containing bedaquiline, delamanid, or both for adolescents with rifampicin-resistant tuberculosis in Khayelitsha, South Africa. EClinicalMedicine, 2020, 20:100290. doi: 10.1016/j.eclinm.2020.100290.
doi: 10.1016/j.eclinm.2020.100290 pmid: 32154506 |
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