Combined drug treatment of tuberculosis. III. Clinical application of the principles of appropriate and adequate chemotherapy to the treatment of pulmonary tuberculosis.
Combined drug treatment of tuberculosis. III. Clinical application of the principles of appropriate and adequate chemotherapy to the treatment of pulmonary tuberculosis.
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结核病的联合药物治疗。
DOI：
10.1172/jci103912
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发表时间：
1959
期刊：
影响因子：
--
通讯作者：
G. Middlebrook
中科院分区：
文献类型：
--
作者：
W. Russell;I. Kass;A. Heaton;S. Dressler;G. Middlebrook
防止耐链霉素和异烟肼结核杆菌突变群体出现的微生物学研究强调，这两种适当药物的适当浓度是必要的(1)。这种浓度的异烟肼向繁殖期寄生虫的输送可以通过微生物测定法来估计(2-4)。用类似的微生物学方法测定具有抗微生物活性的血清链霉素，证实该药物的血清浓度在个体之间也可能有显着差异。这些观察结果表明，不能依靠常规剂量的这些药物来确保每种药物对生理敏感的结核杆菌的体内灭菌浓度。考虑这些原则的结果是为所有患者制定了大剂量链霉素和大剂量异烟肼相结合的化疗方案(5-7)。本报告的目的是介绍这种方法在肺结核化疗中的临床应用结果。
Microbiologic investigation of the prevention of emergence of mutant populations of tubercle bacilli resistant to streptomycin and isoniazid emphasized the fact that adequate concentrations of each of these two appropriate drugs were necessary (1). Delivery of such concentrations of isoniazid to the multiplying parasites can be estimated by microbiologic assay (2-4). Antimicrobially-active serum streptomycin assayed by a similar microbiologic method confirmed that there were also probably significant variations between in-dividuals inserum levels of this drug as well. These observations suggested that conventional dosages of these drugs could not be relied upon to insure the delivery in vivo of sterilizing concentrations of each agent to physiologically-suscepti-ble tubercle bacilli. The result of consideration of these principles was the formulation of a chemo-therapeutic regimen combining high dosage of streptomycin with high dosage of isoniazid for all patients (5-7). The purpose of this report (the third of a series) is to presentthe results of clinical application of this approach to chemotherapy of pulmonary tuberculosis.