The devil we know: is the use of injectable agents for the treatment of MDR-TB justified?
The devil we know: is the use of injectable agents for the treatment of MDR-TB justified?
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DOI：
10.5588/ijtld.17.0468
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发表时间：
2017-11-01
影响因子：
4
通讯作者：
Furin, J.
中科院分区：
文献类型：
--
作者：
Reuter, A.;Tisile, P.;Furin, J.
几十年来，二线注射剂（IA）一直是治疗耐多药结核病（MDR-TB）的基石。虽然关于IA疗效的证据有限，但关于这些药物引起的严重不良事件的证据越来越多。在这里，我们提出了一个结构化的文献综述的安全性和有效性的IA的结果。我们回顾了这些药物在治疗替代方案中的持续广泛使用，最值得注意的是较新的结核病药物，贝达喹啉和地拉马尼，并从人权，伦理和以病人为中心的护理的背景下。我们的结论是，有有限的证据IA的疗效，这些药物的风险的明确证据，并与耐多药结核病患者应了解这些风险，并提供获得替代治疗方案。
For decades, second-line injectable agents (IAs) have been the cornerstone of treatment for multidrugresistant tuberculosis (MDR-TB). Although evidence on the efficacy of IAs is limited, there is an expanding body of evidence on the serious adverse events caused by these drugs. Here, we present the results of a structured literature review of the safety and efficacy of IAs. We review the continued widespread use of these agents in the context of therapeutic alternatives-most notably the newer TB drugs, bedaquiline and delamanid-and from the context of human rights, ethics and patient-centered care. We conclude that there is limited evidence of the efficacy of IAs, clear evidence of the risks of these drugs, and that persons living with MDR-TB should be informed about these risks and provided with access to alternative therapeutic options.