Title:Tuberculosis - Present Medication and Therapeutic Prospects
Volume: 27
Issue: 4
关键词:
结核感染，药物作用机制，结构，用药指南，结核治疗，疫苗。
摘要:
Background: Tuberculosis (TB) has been present in the history of human civilization
since time immemorial and has caused more deaths than any other infectious disease. It is still considered
one of the ten most common epidemiologic causes of death in the world. As a transmissible
disease, it is initiated by rod-shaped (bacillus) mycobacteria. The management of tuberculosis became
possible owing to several discoveries beginning in 1882 with the isolation of the TB bacillus
by Robert Koch. The diagnosis of TB was enabled by finding a staining method for TB bacteria
identification (1883). It was soon realized that a large-scale policy for the treatment and prevention
of tuberculosis was necessary, which resulted in the foundation of International Union against Tuberculosis
and Lung Diseases (1902). An antituberculosis vaccine was developed in 1921 and has
been in therapeutic use since then. TB treatment regimens have changed over the decades and the
latest recommendations are known as Directly Observed Treatment Short-course (DOTS, WHO
1993).
Methods: A search of bibliographic databases was performed for peer-reviewed research literature.
A focused review question and inclusion criteria were applied. Standard tools were used to assess
the quality of retrieved papers.
Results: A total of 112 papers were included comprising original publications and reviews. The
paper overviews anti-TB drugs according to their mechanism of action. The chemical structure,
metabolism and unwanted effects of such drugs have been discussed. The most recent treatment
regimens and new drugs, including those in clinical trials, are also presented.
Conclusion: Despite a 22% decrease in the tuberculosis fatality rate observed between 2000 and
2015, the disease remains one of the ten prime causes of death worldwide. Increasing bacterial resistance
and expensive, prolonged therapies are the main reasons for efforts to find effective drugs or
antituberculosis regimens, especially to cure multidrug-resistant tuberculosis.
