Treatment of pulmonary tuberculosis

摘要: Recently the duration of treatment for pulmonary tuberculosis in The Netherlands was shortened from nine to six months. A months regimen containing isoniazid (H), rifampicin (R) and pyrazinamid (Z) daily two months, followed by H R another four (2HRZ/2HR) has been proven effective tuberculosis, provided cause is a fully susceptible strain M. tuberculosis. Worldwide there an increase drug-resistant Since at start susceptibility tests often are not available, fourth drug must be added intensive phase. Ethambutol preferred. This means that one always starts with 4 drugs unless patient contact index-case sure he will compliant or infected past before 1940, received never tuberculostatic no exogenous reinfection. If treated previously anti-tuberculosis resistance likely, regimens should contain least which before, while fifth routinely Amikacin preferred, since cross-resistance streptomycin. Consensus on extra-pulmonary yet reached, but basically principles same. also true HIV patients. In some serious clinical situations (meningitis, miliary, spine tb) still 9-12 Early involvement public health nurse municipal department (GGD) necessary ensure compliance supervision.