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抗结核药物超说明书用法专家共识

2018-06-13 中华医学会结核病学分会 中华结核和呼吸杂志,2018,41(6) :447-460.

抗结核药物超说明书用法

结核病仍然是危害人类健康的主要传染性疾病之一。2017年世界卫生组织(WHO)全球结核病报告显示，2016年全球结核病发病人数为1 040万，其中儿童发病人数为104万；耐多药结核病(multidrug－resistant tuberculosis，MDR－TB)和利福平耐药结核病(rifampicin－resistant tuberculosis, RR－TB)新发病例60万，广泛耐药结核病(e

中文标题：

抗结核药物超说明书用法专家共识

发布机构：

中华医学会结核病学分会

发布日期：

2018-06-13

简要介绍：

结核病仍然是危害人类健康的主要传染性疾病之一。2017年世界卫生组织(WHO)全球结核病报告显示，2016年全球结核病发病人数为1 040万，其中儿童发病人数为104万；耐多药结核病(multidrug－resistant tuberculosis，MDR－TB)和利福平耐药结核病(rifampicin－resistant tuberculosis, RR－TB)新发病例60万，广泛耐药结核病(extensively drug－resistant tuberculosis，XDR－TB)新发病例3万。我国是全球30个结核病高负担国家之一，也是全球30个MDR－TB高负担国家之一，还是全球30个结核病和人类免疫缺陷病毒感染的高负担国家之一，结核病疫情非常严重。由于抗结核新药开发与研制非常缓慢，耐药结核病尤其是MDR－TB和XDR－TB的治疗非常困难，临床疗效差、治疗费用高、不良反应大。在这种情况下，一方面基于药物说明书的传统治疗方案需要改进，另一方面国内外学者对其他抗结核以外的抗感染药物在抗结核分枝杆菌(Mycobacterium, tuberculosis，MTB)作用方面也进行了较为深入的研究，遴选出了一些具有高效抗MTB作用的药物，并进行了大量的临床试验研究，取得了较好的临床疗效，弥补了抗结核药物研发缓慢的不足，部分药物已经被WHO及我国指南推荐为治疗结核病和耐药结核病的药物[2,3,4,5,6]，但因超出了说明书的用药范围，有些药物又没有相关的指南或共识可以参考，临床应用证据不足，因此，对于抗结核药物超说明书用药有必要达成共识。超说明书用法也称未注册用法，其内容包括超适应证、超剂量、超疗程、超适应人群及改变说明书中规定的用药途径与用药间隔时间等。中华医学会结核病学分会组织全国相关领域专家撰写了"抗结核药物超说明书用法专家共识"。本共识所推荐的超说明书用法均是经过较为长期的临床实践证明且较为安全、有效的用法，包括国内外权威指南或共识推荐的、有循证医学证据支持、发表在权威学术期刊上的研究结果，或学术刊物发表的有一定科学根据的研究结果，但仍需要强调的是，本共识是在现有证据的基础上制定的，尽可能较为全面地涵盖了抗结核药物超说明书使用的相关内容，但由于知识的更新日新月异，加之撰写者水平有限，不足之处在所难免，欢迎广大读者提出宝贵意见，以利于今后进一步完善和修订。 

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评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=326706, encodeId=1b53326e06e9, content=青蒿素应用于抗结核临床只能期待.但一氧化氮的抗结核效用是早已被证实过的.抗结核化疗保肝保肾降尿酸三位一体缺一不可.吃利福平产生的药疹可以抹泰国青草膏.止呕口服大连富生的参百益, beContent=null, objectType=guider, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c2531680715, createdName=1de33e15m69(暂无匿称), createdTime=Sun Jun 24 21:30:48 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325553, encodeId=f0a532555306, content=学习了.谢谢分享!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Jun 20 08:36:24 CST 2018, time=2018-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325493, encodeId=73603254931a, content=了解了解.学习学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed Jun 20 05:48:05 CST 2018, time=2018-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325293, encodeId=651f32529349, content=厉害了我的哥, beContent=null, objectType=guider, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Tue Jun 19 07:13:44 CST 2018, time=2018-06-19, status=1, ipAttribution=)]
    2018-06-24 1de33e15m69(暂无匿称)

    青蒿素应用于抗结核临床只能期待.但一氧化氮的抗结核效用是早已被证实过的.抗结核化疗保肝保肾降尿酸三位一体缺一不可.吃利福平产生的药疹可以抹泰国青草膏.止呕口服大连富生的参百益

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=326706, encodeId=1b53326e06e9, content=青蒿素应用于抗结核临床只能期待.但一氧化氮的抗结核效用是早已被证实过的.抗结核化疗保肝保肾降尿酸三位一体缺一不可.吃利福平产生的药疹可以抹泰国青草膏.止呕口服大连富生的参百益, beContent=null, objectType=guider, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c2531680715, createdName=1de33e15m69(暂无匿称), createdTime=Sun Jun 24 21:30:48 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325553, encodeId=f0a532555306, content=学习了.谢谢分享!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Jun 20 08:36:24 CST 2018, time=2018-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325493, encodeId=73603254931a, content=了解了解.学习学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed Jun 20 05:48:05 CST 2018, time=2018-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325293, encodeId=651f32529349, content=厉害了我的哥, beContent=null, objectType=guider, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Tue Jun 19 07:13:44 CST 2018, time=2018-06-19, status=1, ipAttribution=)]
    2018-06-20 虈亣靌

    学习了.谢谢分享!

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=326706, encodeId=1b53326e06e9, content=青蒿素应用于抗结核临床只能期待.但一氧化氮的抗结核效用是早已被证实过的.抗结核化疗保肝保肾降尿酸三位一体缺一不可.吃利福平产生的药疹可以抹泰国青草膏.止呕口服大连富生的参百益, beContent=null, objectType=guider, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c2531680715, createdName=1de33e15m69(暂无匿称), createdTime=Sun Jun 24 21:30:48 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325553, encodeId=f0a532555306, content=学习了.谢谢分享!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Jun 20 08:36:24 CST 2018, time=2018-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325493, encodeId=73603254931a, content=了解了解.学习学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed Jun 20 05:48:05 CST 2018, time=2018-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325293, encodeId=651f32529349, content=厉害了我的哥, beContent=null, objectType=guider, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Tue Jun 19 07:13:44 CST 2018, time=2018-06-19, status=1, ipAttribution=)]
    2018-06-20 1dd8c52fm63(暂无匿称)

    了解了解.学习学习

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=326706, encodeId=1b53326e06e9, content=青蒿素应用于抗结核临床只能期待.但一氧化氮的抗结核效用是早已被证实过的.抗结核化疗保肝保肾降尿酸三位一体缺一不可.吃利福平产生的药疹可以抹泰国青草膏.止呕口服大连富生的参百益, beContent=null, objectType=guider, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c2531680715, createdName=1de33e15m69(暂无匿称), createdTime=Sun Jun 24 21:30:48 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325553, encodeId=f0a532555306, content=学习了.谢谢分享!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Jun 20 08:36:24 CST 2018, time=2018-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325493, encodeId=73603254931a, content=了解了解.学习学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed Jun 20 05:48:05 CST 2018, time=2018-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325293, encodeId=651f32529349, content=厉害了我的哥, beContent=null, objectType=guider, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Tue Jun 19 07:13:44 CST 2018, time=2018-06-19, status=1, ipAttribution=)]
    2018-06-19 飛歌

    厉害了我的哥

    0