初回治療抗結核療法(ATT)の副作用:代替レジメンは存在するか?
Gauri Goswami1, Pradeep Nirala2, Rajeev Tandon3
1Respiratory Medicine, Royal Oldham Hospital, Manchester, GBR.
Cureus
|February 2, 2026
まとめ
非標準抗結核療法(ATT)レジメンは、肝障害などの有害事象を経験する薬剤感受性結核患者にとって重要である。修正ATTは、強化療法期間中にほとんどの患者で症状と放射線学的転帰を成功裏に改善した。
科学分野:
- 結核治療;薬理学;臨床医学
背景:
- 標準抗結核療法(ATT)は、2HRZE/4HREレジメンを含みます。有害事象や併存疾患は、しばしば非標準化された治療計画を必要とします。
研究 の 目的:
- 非標準ATTレジメンの使用、根拠、転帰を評価する。修正ATTの薬剤感受性結核患者に対する有効性を評価する。
主な方法:
- 三次ケア病院で148人の患者を対象とした前向き観察研究。患者は、有害事象または併存疾患のために非標準ATTを受けました。フォローアップは、治療の強化療法期間に焦点を当てました。
主要な成果:
- 薬剤誘発性肝障害(53.4%)と消化管不耐症(21.6%)が非標準ATTの主な理由でした。HREが最も一般的な代替レジメン(35.1%)でした。76%が臨床的改善を示し、60.1%が強化療法終了までに放射線学的寛解を示しました。修正レジメンで有害事象は認められませんでした。
結論:
- 非標準ATTは、特に肝毒性のような有害薬物反応のために、しばしば必要とされます。修正レジメンは、ほとんどの患者で有意な症状および放射線学的改善をもたらしました。
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