[异烟肼联合利福平治疗潜伏性结核感染]。

Kekkaku : [Tuberculosis] Pub Date : 2016-10-01
Kunihiko Ito
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摘要

【目的】对各国临床研究和国家指南进行文献综述,探讨日本是否应引入异烟肼和利福平联合治疗潜伏性结核感染(LTBI)的方案。【方法】临床研究方面,回顾文献中23项非随机研究和10项随机研究。[结果]异烟肼与利福平联合治疗的患者([HR];大部分为3个月),与接受异烟肼单药治疗的患者相比([H];主要是6 ~ 9个月),肝功能障碍的频率和严重程度趋于降低,但药物不良反应普遍增加。接受HR治疗的患者治疗完成率往往高于接受h治疗的患者。HR的预防效果似乎至少与h相当,或者在某种程度上优于h。本研究回顾了欧盟和其他国家的许多国家指南,推荐HR作为LTBI治疗方案,并且通常提供了高水平的证据。【结论】3HR治疗已经在许多临床和随机研究中得到了很好的研究,并且似乎已经获得了很高的优点,以便在日本作为LTBI治疗方案之一引入。
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[TREATMENT OF LATENT TUBERCULOSIS INFECTION WITH A COMBINATION OF ISONIAZID AND RIFAMPICIN].

[Purpose] To conduct a literature review on clin- ical studies and national guidelines in various countries, for the purposes of facilitating discussion regarding whether latent tuberculosis infection (LTBI) treatment regimens com- posed of isoniazid and rifampicin should be introduced in Japan. [Methods] For clinical studies, 23 non-randomized studies and 10 randomized studies in the literature were reviewed. [Results] In patients who had received treatments com- posed of isoniazid and rifampicin ([HR]; largely 3 months), compared with those who had received isoniazid monother- apy ([H]; largely 6 to 9 months), both frequency and sever- ity of liver dysfunction tended to be reduced, but adverse drug effects increased in general. Treatment completion rate tended to be higher in those who had received HR than in those who had received H. Preventive effects of HR seemed to be at least equivalent, or somewhat superior, to H. Many national guidelines of the European Union and other coun- tries reviewed in this study recommended HR as an LTBI treatment regimen, and generally provided a high level of evidence. [Conclusion] 3HR treatment has been well studied in many clinical and randomized studies, and seems to have garnered a high level of merit in order to be introduced as one of the LTBI treatment regimens in Japan.

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