关键词: 结核,抗多种药物性, 泛耐药结核病, 药物疗法,联合, 方案评价, 结果与过程评价(卫生保健), 贝达喹啉

Abstract:

Difficult-to-treat multi/extensively drug-resistant tuberculosis (MDR-TB/XDR-TB) is an extremely lethal infectious disease which still pose a threat as a global public health issue. With the development of new drugs such as bedaquiline (Bdq), delamanid or pretomanid, the regimens of Bdq plus background regimen (BBR) have achieved amazing treatment success rate. Bdq can be safe and effective when continued for up to 18 months, and it can also benefit children, adolescents, pregnant women, positive HIV patients and other special groups. However, the inevitable issues, including primary and acquired drug resistance, cross-resistance, recurrence, prolonged Q-T interval, and increased mortality and side-effects caused by the combined treatment with delamanid, pretomanid, or clofazimine, can not be ignored. In order to make the new drug Bdq exert a long-term clinical treatment effect, the understanding of the side-effects of Bdq should be enhanced, and the corresponding treatment and protection measures should be taken. Meanwhile, the premature occurrence and spread of Bdq resistance should be avoided.

Key words: Tuberculosis,multidrug-resistant, Extensively drug-resistant tuberculosis, Drug therapy,combination, Program evaluation, Outcome and process assessment (health care), Bedaquiline