In modern conditions for the treatment of tuberculosis are designed scheme scrutinized doses and combinations of drugs, but TB remains topical problems of modern.Although half a century has passed since then, it was discovered streptomycin and isoniazid, the last remains by far the most active against the drug, however, and Koch's bacillus for many thousands of years of existence in the human body is perfectly adapted to the constantly changing conditions.Let's talk about drugs to treat tuberculosis person!
This is reflected now in the emergence of resistance to anti-TB drugs (TAP).Although we now have a sufficient arsenal of means to suppress, in the case of multidrug resistance of Mycobacterium polyresistance or treatment of the patient is much more complicated.
Treatment of pulmonary tuberculosis specific anti-TB drugs include the following tasks:
- suppression of reproduction of Mycobacterium tuberculosis and the prevention of their spread in the body;
- bacteriological avoid possible contamina
- achieving clinical cure of the human condition with minimal functional loss and residual changes;
- prevention of relapse of the disease.
But even the most powerful anti-TB drugs can only suppress the activity of reproduction in the human body, but do not destroy them completely.In addition, even in concentrations of many anti bacteriostatic agents have severe side effects, because of which patients often refuse to receive them.Due to the forced reduction of dose in these patients is reduced and the concentration of drugs in the body, and quickly learn to be in their presence.There is a category of undisciplined patients who forget to take medication, missing sometimes for several days, or cancel their own drugs to the poor, in their view, effect.In such circumstances, continue to multiply.As a result, cure such a patient can be achieved only with the use of relatively expensive second-line drugs as the most effective means in the first row of them are no longer active.Either tuberculosis becomes chronic with the most adverse effects on the body.And if this person continues to have bacteriological then infects others it is their mycobacteria resistant to anti-TB drugs.
fundamental tenet of modern TB is taking medication in doses established and well defined course.At the beginning of the treatment of patients with newly diagnosed acute processes are in phase of activity, they multiply rapidly and are located mainly extracellularly.Therefore TAP affect them as efficiently as possible and under optimum conditions and strict adherence and dose of drugs such patients fully recover.Treatment in this case continues from year to year and a half, and usually 3-6 months later lose their activity and mostly hidden from PTP within phagocyte cells, which destroy pathogens already difficult.In addition, they have a significant variability, they may change their form, or go into a dormant state.In the latter case, they act is no longer possible.Such latent forms are subsequently activating source of infection for the body under adverse conditions.
TB treatment in connection with such peculiar behavior of Mycobacterium reasonably divided into two phases:
- phase of intensive treatment, when the patient receives the most highly active anti-TB drugs,
- phase of follow-up care as to prevent the re-activation of dormant and intracellularly located necessaryA lesser number of anti-TB drugs.During the aftercare phase, in addition to the past, use all kinds of therapy to improve immune status and increase its resistance to infection, as well as activation of regenerative processes in affected organs.
Very often, premature discontinuation of PCP, when a patient comes a significant improvement in the condition and state of health, not only leads to the formation of drug resistance, but also to the aggravation of tuberculosis.Further treatment in such cases more complicated and increases its durability.The same applies to chronic forms of tuberculosis, where patients spend on the treatment of almost all released their lifetime.
fresh Cure Tuberculosis is an achievable, the real goal, which requires implementation of the recommendations of the doctor and regular intake of anti-TB drugs for 12-18 months.At the same time the treatment of chronic and tuberculosis caused by drug-resistant forms, is a very complex task for which it is necessary to involve the whole reserve of medication and medication, including non-traditional therapies.
stands out among anti-TB drugs 3 main groups:
- the most effective drugs - isoniazid and rifampicin (rifadin);
- average efficiency of drugs - ethambutol, streptomycin, protionamid, ethionamide, pyrazinamide, kanamycin, cycloserine, florimitsin;
- the least active drugs - PAS and tibon.
impact of anti-TB drugs to Mycobacterium tuberculosis is diverse and consists of a violation of their metabolic and enzymatic activity, stunted growth and reproduction, reduce aggression towards macroorganism.Most often in the treatment of newly diagnosed patients with acute tuberculous process using standardized scheme.