[Mycobacterial bases of the therapy of mycobacterioses]

Atypical mycobacteria are very often naturally resistant to antituberculosis drugs used in the therapy of tuberculosis. In contrast they are in vitro sensitive to some nonspecific antibiotics and sulfonamides. While the classical mycobacteria in their sensitivity to antituberculosis drugs are homogenous, atypical mycobacteria are very heterogenous. This heterogeneity occurs not only in different species, but inside of each species as well. For these reasons the therapy of mycobacterioses demands a deep analysis of the causative agent in the sense of its sensitivity using the analytic quantitative proportional sensitivity test. With this test it is possible to determine the frequency of the primary resistant population to one million viable mycobacterial units. In the therapy of mycobacterioses in comparison to tuberculosis and antituberculosis drugs does not exist any universal therapeutic regimen. The therapy of mycobacterioses needs a combined therapy including such therapeutic drugs as antituberculotics, nonspecific antibiotics, sulfonamides and antileprotics in which the frequency of primary resistant population will be lowest.