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首页> 外文期刊>Antimicrobial agents and chemotherapy. >Tuberculosis and trimethoprim-sulfamethoxazole.
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Tuberculosis and trimethoprim-sulfamethoxazole.

机译：结核和甲氧苄氨嘧啶磺胺甲基恶唑。

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The sulfonamides were the first drugs with antituberculous effects. Their use was abandoned and basically forgotten with the advent of streptomycin and isoniazid combination treatment. There is a widespread belief, apparently based on testing a single isolate on questionable media, that Mycobacterium tuberculosis is resistant to trimethoprim-sulfamethoxazole (TMP-SMX). We saw a complex immunocompromised patient with tuberculosis who was initially treated with TMP-SMX without antituberculous drugs and defervesced on this treatment. An isolate of M. tuberculosis from this patient was found to be sensitive to TMP-SMX. We examined how frequently M. tuberculosis is sensitive to TMP-SMX. Isolates were tested for susceptibility to TMP-SMX on supplemented Middlebrook 7H10 plates. We found that 43 of 44 (98%) isolates of M. tuberculosis were susceptible to the combination of < or = 1 microg/ml of TMP and 19 microg/ml of SMX (< or = 1/19 microg/ml). Thus, the vast majority of our M. tuberculosis isolates were susceptible to TMP-SMX at an MIC similar to that for Mycobacterium kansasii, Mycobacterium marinum, and sensitive rapidly growing mycobacteria, organisms successfully treated with TMP-SMX as part of the treatment regimen. It is possible that TMP-SMX may be useful in treating patients with multiple-drug-resistant and extended drug-resistant tuberculosis. We feel that a clinical trial looking at the effectiveness of TMP-SMX as an antituberculous drug is worthwhile.
机译：磺胺类药物是第一种具有抗结核作用的药物。随着链霉素和异烟肼联合治疗的出现，它们的使用被放弃并基本被遗忘。人们普遍认为，显然是基于在可疑培养基上测试单个分离株，结核分枝杆菌对甲氧苄啶-磺胺甲基异恶唑（TMP-SMX）具有抗性。我们看到了一名复杂的免疫功能低下的结核病患者，该患者最初接受了TMP-SMX的治疗，而没有使用抗结核药物，但随后推迟了治疗。发现该患者的结核分枝杆菌对TMP-SMX敏感。我们检查了结核分枝杆菌对TMP-SMX敏感的频率。在补充的Middlebrook 7H10平板上测试分离株对TMP-SMX的敏感性。我们发现，结核分枝杆菌的44个分离株中有43个（98％）易受TMP≤1μg/ ml和SMX（19μg/ ml）（≤或= 1/19 microg / ml）的结合。因此，我们的大多数结核分枝杆菌分离株对MIC的TMP-SMX敏感性与堪萨斯分枝杆菌，海分枝杆菌和敏感的快速生长的分枝杆菌相似，作为治疗方案的一部分，成功用TMP-SMX治疗的生物体。 TMP-SMX可能对治疗多重耐药和长期耐药结核病有用。我们认为，一项有关TMP-SMX作为抗结核药有效性的临床试验是值得的。

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