1

GLOBAL
EMERGENCY ..
2543
5-10

(Recommendations)

(retreatment)

6 2 HRZE(S)/4 HR
H = isoniazid 300 ./, R =
rifampicin 10 ././, Z = pyrazinamide 25 ././, E = ethambutol 15 ./
./, S = streptomycin 15 ././

rifampicin
6
isoniazid
isoniazid rifampicin pyrazinamide
streptomycin ethambutol
creatinine clearance

(multidrug resistant-TB, MDR-TB)

aminoglycoside, ethambutol, quinolone

(bilirubin )

SGPT, SGOT alkaline phosphatase

3-5
3-7
(liver failure)




2
2 4 1 2
4 4

2 /

5

2 2 4
4
directly observed therapy (DOT)

4 1
+ 2

6 7

4
4

AFB

1-2
+ 3

5
+

isoniazid, rifampicin, pyrazinamide




- -


1- 2 2

aminoglycoside, ethambutol, quinolone

1. 5
2. 3
-
3.



aminoglycoside ethambutol
quinolone
2
(drug challenging) isoniazid 100 .
200 300 .
3
rifampicin 150 .
pyrazinamide 500 .

ethambutol
[2SHRE/6HR, 6RZE,
2HRE/7HR, 2HZE/10HE, 9RE, 2SH(R)E/10H(R)E, 2SOE/16OE]

3-5

1. 5 isoniazid 6 5 ./
./
2. 5-15 isoniazid
(treatment of latent tuberculous infection)
- > 15 .
- > 5 .
3. 15

() > 5 . 9 ( isoniazid 300 ./)

10

(retreatment)




quinolone

3
1. (relapse)
2. 2 (default)
3. (treatment failure)
3.1 5

3.2 2

relapse

default
(2SHRZE/1HRZE/5HRE)
treatment failure

3
6

(fall and rise phenomenon)

relapse
default default

11

1. , , .
( 2), 2543.
2. World Health Organization. Treatment of tuberculosis: guidelines for national
programmes, second edition, 2003.
3. American Thoracic Society/Centers for Disease Control and Prevention/Infectious
Diseases Society of America. Treatment of tuberculosis. Am J Respir Crit Care Med
2003; 167:603-62.