[我院抗结核新药delamanid在多重耐药和广泛耐药结核病中的应用体会]。

Kekkaku : [Tuberculosis] Pub Date : 2016-11-01
Masao Okumura, Takashi Yoshiyama
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引用次数: 0

摘要

[目的]了解我院抗结核新药Delamanid在多重耐药和广泛耐药结核病(M (X) DR-TB)中的应用情况。【材料与方法】我院2014 - 2015年诊断为M(X)DR-TB的15例患者使用Delamanid治疗。[结果]M(X)DR-TB患者性别分布为男性11例,女性4例。男性平均年龄53.3岁,女性平均年龄28.3岁。日本8例,中国5例,其他国家2例。12例为耐多药结核病例,3例为广泛耐药结核病例。15例患者中6例在使用Delamanid前痰培养阳性。Delamanid在心电图上出现QTc延长2例(13.3%)。但这些病例均未出现症状。其他典型的副作用还没有发现。15例患者中6例(40.0%)行手术切除。15例患者中1例因难治性气胸死亡,1例因白细胞减少而停药。所有含2例中止病例的患者痰培养均为阴性转化。[结论]我们经历了新的抗结核药物Delamanid。如果我们只给耐多药结核病患者添加Delamanid,只有一种或两种敏感的抗结核药物,将有可能产生新的耐药性。我们使用了另一种新药,如利奈唑胺或大剂量异烟肼或美罗培南和氨苄西林克拉维酸与德拉曼尼和敏感的抗结核药物。当我们使用新的抗结核药物时,我们需要调查风险和收益。我们不需要再制造更多的耐多药结核病病例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[EXPERIENCE OF USE OF NEW ANTI-TUBERCULOUS DRUG, DELAMANID IN MULTI- AND EXTENSIVELY DRUG RESISTANT TUBERCULOSIS CASES IN OUR HOSPITAL].

[Objective] We experienced use of new anti- tuberculous drug, Delamanid in multi- and extensively drug resistant tuberculosis (M (X) DR-TB) in our hospital. [Materials and Methods] Fifteen cases who were diagnosed M(X)DR-TB had been used Delamanid in our hospital from 2014 to 2015. [Results] The gender distribution consisted of eleven males and four females in M(X)DR-TB. The mean age was 53.3 years old in male and 28.3 years old in female. Japanese were eight cases, and Chinese were five cases, and other countries patients were two cases. Twelve cases were MDR-TB cases, and three cases were XDR-TB cases. Six cases of fifteen cases were sputum culture positive before using Delamanid. Two cases (13.3%) had been appearanced QTc extension in EKG by using Delamanid. But these cases had not seen symptom. Other typical side effects had not seen. Six cases (40.0%) of fifteen cases had done surgical resection. One case of fifteen cases had been died with intractable pneumothorax, and one case had been discontinued for leukopenia. All cases containing two discontinued cases had obtained negative conversion of sputum culture. [Conclusion] We experienced new anti-tuberculous drug, Delamanid. If we add Delamanid only for MDR-TB patients with only one or two sensitive anti-tuberculous drugs, it will be possible to make anew resistance. We used one more another new drug, for example Linezolid or high dose isoniazid or Meropenem and Ampicilin Clavulanate acid with Delamanid and sensitive anti-tuberculous drugs. We need to investigate risk and benefit when we use new anti-tuberculous drug. We need not to make more another MDR-TB cases.

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