肺結核の再発について

概要

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There are two key drug actions in short-course chemotherapy. One is bacteriostatic or bactericidal activity, that is, inhibiting or killing dividing bacilli. Most of the antituberculous drugs possess these activities. An other is sterilizing activity, that is, killing the so-called “persisters” which are scarcely metabolizing and much less dividing.<BR>RFP has special abilities to eliminate “persisters”.Elimination of persisters is the most important key in relation to the relapse occurring after the completion of the short-course chemotherapy.<BR>Relapse is defined as 2 or more positive cultures of tubercle bacilli each with more than 20 colonies found after the completion of treatment. Bacteriological relapse is divided into two types, one is early relapse, which occurs within 1 year after completing treatment, and the other is late relapse, which occurs 2-3 years or more after completing treatment.<BR>It is very difficult to analyze clinically the factors relating to relapse after completing the chemotherapy because the rate of relapse after modern chemotherapy with regimens including RFP is very very low. Relapse is considered to occur in relation to the impairment of immunity.<BR>General concept of relapse in tuberculosis and further important topics in relation to clinical diagnosis of relapse were discussed in this paper.
日本結核病学会の論文