Prevention of drug resistance by combined drug treatment of tuberculosis.
Prevention of drug resistance by combined drug treatment of tuberculosis.
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DOI：
10.1007/978-3-642-28951-4_6
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发表时间：
2012-01-01
影响因子：
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通讯作者：
Mitchison, Denis A
中科院分区：
文献类型：
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作者：
Mitchison, Denis A
人们认为，抗结核药物组合治疗的作用是，第一种药物杀死对第二种药物耐药的突变体，而第二种药物则杀死对第一种药物耐药的突变体。联合治疗在预防结核病治疗过程中耐药性的出现方面取得了显着的成功。这一成功导致了针对麻风病、艾滋病毒感染和癌症的多种药物治疗的引入。它在结核病治疗中的成功取决于许多条件，例如结核分枝杆菌耐药性的染色体性质、不存在携带耐药因子的质粒，以及结核病细菌群体不与其他潜在耐药细菌接触的方式。为了使多药治疗有效预防耐药性，药物必须具有足够的活性，以便每种药物都能抑制病变中的所有细菌。生长重新启动时还必须存在有效的抗生素后滞后，以防止剂量之间的生长。具有耐药性或在药物作用下异常成功地存活下来的特殊细菌群体也是潜在的耐药性来源。
Treatment with a combination of anti-tuberculosis drugs is thought to work by the first drug killing mutants resistant to the second drug, while the second drug kills those resistant to the first drug. Combined treatment has been remarkably successful in preventing the emergence of resistance during the treatment of tuberculosis. This success has led to the introduction of multi-drug treatment for leprosy, HIV infections and cancer. Its success in tuberculosis depends on a number of conditions such as the chromosomal nature of drug resistance in Mycobacterium tuberculosis and the absence of plasmids carrying resistance factors as well as the manner in which the bacterial population in tuberculosis does not come into contact with other potentially resistant bacteria. For multi-drug treatment to be effective in preventing resistance, the drugs must be sufficiently active so that each can inhibit all the bacteria in lesions. There must also be effective post-antibiotic lags in growth restarting to prevent growth between doses. Special bacterial populations that are drug tolerant or survive drug action unusually successfully are also a potential source of resistance.