2010 4 32 4 181 (2009) [],,,2002 ( ),, 13 (2009),, 1, 1 4 111 ( monoresistance) 1 112 ( polyresistance) 1, 113 ( multidrug resistance, MD R) 114 ( extensively drug resistance, XD R),, 3 ( ) 1 2 211,, (W HO) 5, W HO,1 4, 4, 5 (1) 212 1, 1 ( ) 1 ( H) ( R) ( E) ( Z) ( Rft) ( Rfb) 2 (S) ( Km) (Am) (Cm) 3 (Ofx) (Lfx) (Mfx) 4 ( Eto) ( Pto) (Cs) ( Trd) ( PAS) ( Pa) ( Thz) 5 MDR2TB ( Fz) (Lzd) ( Amx Clv) ( Clr) ( Ipm) :(xiaoheping_sar @163. com)
182 2010 4 32 4 21211 ( Isoniazid) 2121111 C6 H7 N3 O, 137114 2121112, 2121113,,,,,,,, (1620 mg/ ( kg d) ), 2121114 ;,(1) : 300 mg (58 mg/ kg), 300 mg (1015 mg/ kg) ; (2) : 600 mg ; (3) :,, 1 ;, 2121115 (1),, (2), 10 %20 %, 2,20 210 g (3) : ;, ; ; 2121116 (1), B6, B6, B6 (2), ;,(3) 21212 ( Pyrazinamide) 2121211 C5 H5 N3 O, 123112 2121212,,,,,,, 2121213,, p H, (p H 516),,, 45,,,,6, 2121214 (1) : 115 g (2030 mg/ kg), 3040 mg/ kg(2) :< 50 kg, 115 g, 50 kg, 2121215 (1),,,, (2) ( ),,, (3),,,,,
2010 4 32 4 183 2121216 (1) ;(2),, 21213 ( Et hambutol) 2121311 C10 H24 N2 O2 2 HCl, 277123 2121312 RNA, 2121313, p H,,,,, ;, 34 2121314 (1) : 0175110 g (1520 mg/ kg), 15 mg/ kg, (2) : < 50 kg, 110 g, 50 kg, 1125 g 2121315 (1),,, (2) ( 15 mg/ kg), 2121316 (1), (2) (3),, (4),, 21214 (Rifampicin) 2121411 C43 H58 N4 O12, 822195 2121412 DNA RNA, RNA,DNA, RNA 2121413,,, 2121414 (1) : 8 10 mg/ kg 50 kg, 450 mg/ d ; 50 kg,600 mg/ d1020 mg/ kg (2) : 600 mg 2121415 (1),, (2), (3) (4), 2121416 (1) (2), 016 g 21215 (Rifapentine) 2121511 C47 H64 N4 O12, 877103 2121512 : 2121513 (1),,, 10 mg/ kg, 45 d, 1 d 1, 6 (2) 2121514 600 mg 450 mg 1 2 2121515, 2121516 21216 (Rifabutin) 2121611 C46 H62 N4 O11, 847100 2121612 DNA RNA, 2121613
184 2010 4 32 4,,, 2121614 300 mg,1 / d (2) 2121615 (1), (2) 1 % (3) T 2121616 (1) H IV/ A IDS, MAC ( ), (2), (3), 3,,,,, 213 21311 (Streptomycin) 2131111 (C21 H39 N7 O12 ) 2 3 H2 SO4,1 457140 2131112,, RNA,, 2131113,,,,,,,, 2131114 (1) : 0175 g, 2030 mg/ kg,,0175 g(2) : 0175110 g, 2131115 (1),,,, ;,, (3),, (4),, 12 min 10 min,,, 2131116 (1), (2),,,,1 23 (3), 21312 ( Kanamycin) 2131211 C18 H36 N4 O11 n H2 SO4,484150 2131212 2131213,,, 2131214 (1) 0175 g,, 1 / d, 15 mg/ kg (2),015 g,1 / d,0175 g,, 1 (3) 7 mg/ kg 2131215 (1),, ( : ) (:, ) (2) 2131216 (1),,(2)
2010 4 32 4 185 (3), (4) (5) ;,,, 21313 (Amikacin) 2131311 C22 H43 N5 O13 n H2 SO4,762115 ( n = 18) ;781176 ( n = 2) 2131312 2131313,,,,,,,, 2131314 (1) 400 mg, 400 mg 100 ml,1 / d, (2) :48 mg/ kg, 2131315 2131316 (1), (2) (3) ( MIC 110g/ ml),, (4) (5) (6), 21314 (Capreomycin) 2131411 C25 H46 N14 O11 S, 750178 2131412, 2131413,,, 2131414 7501 000 mg,, 2131415 (1), (2) 2131416 (1) (2) (3) (4), (5), (6) 214 21411 (ofloxacin, Of x), (levo2 floxacin, Lf x), ( moxifloxacin, Mf x), (gatifloxacin, Gf x) 21412, (DNA) ( ), DNA 21413, (MIC90 0125g/ ml) (MIC 015g/ ml) (MIC 110g/ ml) 2,4 2 ( MBC), ( MBC 015g/ ml), ( MBC 2 g/ ml ) ( MBC 4g/ ml) ( FQ) 21414 (1) 600 800 mg, 400 600 mg, 400 mg, 400 mg, 1,,1 (2), 21415 (1) : (2) :, (3) : ( ) 21416 2141611,
186 2010 4 32 4 2141612 18 2141613 2141614,,,, 2141615,, 2141616 2141617 2141618, 2141619, 21416110 ( ) ( ), 21416111 ( ), 21416112, P450,,,, : > >,,,,,,,,,,, 215 21511 ( Et hionamide) 2151111 C8 H10 N2 S, 166124 2151112 2151113, 1/ 10 2151114 1 015018 g,1 (),(013 g/ d) 2151115 (1), 23,,,,, (2) 2151116 (1) 20 %30 %,,, 1 (2) 12 (3) 21512 ( Protionamid) 2151211 C9 H12 N2 S, 180128 2151212 2151213,, (MIC) 016g/ ml,,, ; ; 2151214 (1) 600 mg, ( 200 mg/ d) (2) :1020 mg/ kg,3 2151215 (1) ( ) (2) () ( ) ( ) (3) ( ) ( )
2010 4 32 4 187 (4) : ( ) ( ) ( ) 2151216 (1) (2),,, (3),B,B6 B2 (4), (5), 2151217,,,,,( ),, ( ), ( ) (200 mg),35 d 21513 (Cycloserine) 2151311 C3 H6 N2 O2, 105109 2151312 L2 D22D2, 2151313, MIC 520g/ ml,,3 2151314 : 2 12 h 250 mg ;,68 h 250 mg, 1 g/ d 2151315 (1) ( ) (2) ( ) ; () ; 2151316 (1), (2) ;; (3),, ( ) (4), 2151317 ( ) C14 H14 N4 O4, 302129, 2,,,, ( ),,, 21514 (Aminosalicylate) 2151411 C7 H6 NNaO3 2 H2 O,211114 2151412, 2151413, ;,, 2151414 (1), 8 g,3 8 g, 2 48 g 5 % 3 %4 %,23 h,,, (2) :200300 mg/ kg 2151415 (1) :,, (2) :, (3) :, (4) : (5) :
188 2010 4 32 4,;, 2151416 (1) (2) ;, (3),, (4),2 68 h, (5), (6),, (7) C,, C,, ; (4) : (8) (9), (10) 2151417,,,, 42242,, 21515 ( Thioacetazone) 2151511 C10 H12 N4 OS, 236129 2151512, 2151513, 1 mg/ L, 46 30 %,,, (/ ) /, (), 2151514 (1) 1 2550 mg,1 d 100150 mg ; (2) 10 kg 1 25 mg,10 20 kg 1 50 mg,2040 kg 1 100 mg, 23 2151515,1 > 100 mg, 68 % ; 1 < 100 mg, 26 %(1) : (2) :, ; (3) : (5) :, Stevens2Johnson (, ) (6) : 2151516 (1),,H IV,Stevens2Johnson,HIV/ A IDS (2), (3), (4) (5) 216, 21611 (Clofazinmine) 2161111 C27 H22 Cl2 N4, 473140 2161112, DNA, DNA RNA, RNA,, 2161113
2010 4 32 4 189,,, 2161114 300 mg ; 2161115 (1) 2, 2,12,,,,, (2) 70 %80 %,,, 23 (3) (4) (5), 2161116 (1), (2) (3) 100 mg, (4) :, (5), (6),, 21612 (Linezolid) 2161211 C16 H20 FN3 O4, 337135 2161212,, 50S 30S, 70S 2161213,, (MRSA) ( VREF),,, 2161214 1 200 mg (50 mg/ kg) 2 2161215,,,,, 2161216 (1) ; (2), 2, (3) (4) ; 52, 52 21613 (Amoxicillin and Cla2 vulanate Potassium) 2161311 2,, 2161312 : 2 400 4 800 mg,23 : 1 300 1 950 mg,23 2161313 (1) (2), (3) (4) 2161314 (1), (2) (3),, (4)
190 2010 4 32 4 ;, 1 (5), 1/ 41/ 3,;,, (6),, ; 21614 (Azit hromycin) ( Clarit hromycin) ( Roxit hro2 mycin) 2161411, 50S,, 2161412, ( ), ( ),, ;, 2161413 : 50 kg 500 mg,2 ; > 50 kg 750 mg, 23 715 mg/ kg 2161414, 2161415 (1),,(2),,,(3) 12, 21615 ( Imipenem) 2161511 C12 H17 N3 O4 S H2 O, 317136 2161512 ( PBPs),PBP1a PBP1b PBP2,, 2161513,, 2 1, 3,,, 2,, D 217 21711 ( Telit hromycin), 3, 6 10,, 57 %, 10 h, 21712 R207910, 12(62 2222 232)2 42 222212212 2 222 R207910, R207910 R207910 A TP,A TP, R207910 MIC 01030112g/ ml, (SHREZ ), R207910,, 431764 h, 281192 h, R207910 HRZ 2 HRZ, Cmax AUC R207910, R207910 21713
2010 4 32 4 191 PA2824,,2002 PA2824 PA2 824 MIC 01015 0125g/ ml,h (010301 06g/ ml), PA2824 (persister),,pa2824 50 mg/ (kg d) 25 mg/ (kg d), 1215 mg/ (kg d), ( minimal bactericidal do se, MBD) 100 mg/ (kg d) 21714 SQ109,, SQ109 2,, SQ109, MIC 0110163g/ ml SQ109,, MIC,,, (2118 10-9 ), SQ109 21715 BM212 BM212 1, 52222 232(42 212) 2 BM212 MIC 017115g/ ml,h S ; (),MIC 017115g/ ml BM212 218 21811,,, 1 1, kg,, 800 mg/ d, 2, 400 mg/ d,, 600 mg/ d,750 mg/ d,, 1620 mg/ (kg d),w HO, 21812 2181211, 2,,,,,, 2181212 (post2antibiotic effect, PA E),,,,,,,, 2181213,,,5,, 1 2181214,,,
192 2010 4 32 4 2 (mg/ d) mg/ kg a 50 kg 50 kg (mg/ d) (/ d) 10 300 300 300 b 1 3040 1 500 1 750 2 000 13 1525 750 1 000 1 500 12 1020 450 600 600 1 1020 c 450 600 600 2 150300 300 12 1520 750 750 1 000 1 15 400 600 800 12 1520 750 750 1 000 1 1520 400 600 800 12 10 400 500600 750 1 71510 400 400 400 1 1520 600 800 800 23 1520 500 750 1 000 23 200 800 1 000 1 200 1 200 800 1 000 1 200 1 5 100 150 150 23 100 150 300 1 30 1 200 1 200 1 200 2 d 50 1 300 1 950 23 71 5 500 750 1 000 23 60 e 1 500 2 000 4 000 2 a) < 33 kg ;b), 1620 mg/ kg ;c) ;d), kg ;e) 2 000 mg 3 311 31111, 31112 /,, 31113,, 31114,,, 31115 312 31211 4 5 1, 23 31212,, 31213 1, 3, 6 12 31214 14
2010 4 32 4 193 5, 31215 918 (3,615 ), 24 ( 612,1824 ) 31216 2,1,2,,, 31217,,,1 d ;,3 31218 (DO T) 313 31311,,, +, + ; 3 + + 31312, 31313,,,,,,,24,, 31314,, 31315, 2 31316 20 90,,,, 4 411, 3 3 41111, 41112,,, 41113,, ;,, 412 41211 4121111 ( ),, 4121112,,,, 4121113, 41212 4121211,, 4121212 4121213,
194 2010 4 32 4,, 5 511 51111,,, ;, ; ;, ;,,,,,,, 512 51211 51212, 51213, 1 51214 3,34 6 51215 PZA 51216 12, 9,2 12,34 18 51217, 513 51311 5131111 : 3RZSE Of x (Lf x) / 6RZE Of x (Lf x) :, 3, 9 5131112 : 3 HZSE Of x (Lf x) / 9 EHZ Of x (Lf x) :,,3, 12 51312 2 5131211 : 3ROf x (Lf x) Am ( Km) E Z/ 9ROf x (Lf x) E Z : () ( ),, 3, (), 12 5131212 : 3 HOf x (Lf x) Am ( Km) E Z/ 9 HOf x (Lf x) E Z : ( ) (), ( ) 3, () 12 5131213 34 :6R ( H) Of x (Lf x) Am ( Km) Z P/ 12R ( H) Of x (Lf x) Z P :( ), 6,,18 514 51411,, 3,4 5,,,,, 51412 5141211,, 5141212 1,, 6
2010 4 32 4 195 3 1 2 H 3RZSE Ofx (Lfx) / 6RZE Ofx (Lfx), R 3 HZSE Ofx (Lfx) / 9 EHZ Ofx (Lfx), H 3ROfx (Lfx) Am( Km) E Z/ 9ROfx (Lfx) E Z, R 3 HOfx (Lfx) Am( Km) E Z/ 9 HOfx (Lfx) E Z, 34 6R/ HOfx (Lfx) Am( Km) Z P/ 12ROfx (Lfx) Z P, R H 6Am( Km,Cm) Ofx (Lfx) P(Cs) ZPto ( E) / 18Ofx (Lfx) P(Cs) ZPto ( E) a), ( ) 5141213 23,,, 5141214,PZA 5141215 14,2 5,H IV/ A IDS 51413 6Am ( Km, Cm) Of x (Lf x) P ( Cs) ZPto ( E) / 18Of x (Lf x) P(Cs) ZPto ( E) 51414 5141411,,( ), 6, 24 5141412 4 (1), 2 ; +, + + + (2), 2 4 ; 3 4 515,,,, 51511, 51512 1, 12 51513 1 4 2 5,, (1620 mg/ kg) 51514 51515 24 6 611 61111 61112 61113 61114, 612 61211 6,,, 61212 6121211 6121212 6121213,/ 61213 6121311, 6121312 6121313 7
196 2010 4 32 4 711 71111,12, 5, 30 d 71112,12, 1, 3, 30 d : 712, (12 5 ), 713 714 71411 12 5 2 2 71412 3 1, 71413 ( ) 715 2 716 717 8,,, 4, 4,, 4 a,, 1. 1. 2. () 3. B6 (200 mg/ d) 2. / 4.,, 5., 3.,,,,, 3., /, 1. B6 (200 mg/ d) 2., 4., 5., 1. ( HIV ),, 2.,,, 1., 1., 2.,, 3., ( 3 ) 2. 4., 3.,,, 1. (14 ) 1., / 2. 2., 3., 3.,
2010 4 32 4 197 a 4, 1. 1., / 2.,, 2. 3.,, / 1. / 2. / / 1.,, 2.,, 3., 2.,,,, 3. 1., 4.,,,, / 2. (17 d) 1. H2 3., 1. () 2., 2 h 3.,, 1., 2. /, 3.,, 1., 2.,, 1. 1. 2.,,,, 3. (2 2. 3 / ) 4., 1. 1.,, 2.,( 2. (510 mg/ d) (25 mg/ d) ) 3.,, 1. 2. 1. 2., 1. 1., 2., 2., a)
198 2010 4 32 4 5 a < 30 ml/ min b (mg/ d) 300 1 / d 600 1 / d 2535 mg/ (kg ) 3 / 1525 mg/ (kg ) 3 / c 1215 mg/ (kg ) 23 / c 1012 mg/ (kg ) 23 / c 1215 mg/ (kg ) 23 / 600800 mg/ 3 / 7501 000 mg/ 3 / 400 1 / d 250 d 1 / d 600800 23 / d e 8001 200 13 / d a) : 2008 b),, c), d) 250 mg, (,, ) e),,, (5) 9, 24,,,,,,,, /, (), () ( ),,,,,,, ( :2010-02 - 26) ( : )