rezistentuli tuberkulozi

amis gamo, upiratesoba eniWeba ofloqsacinsa da levofloqsacins.zogierT gamonaklis SemTxvevaSi DR-TB konsiliumTan erTad SesaZloagadawydes moqsifloqsacinis gamoyeneba. es is SemTxvevebia, rodesaczogierTi meore rigis medikamentis mimarT rezistentoba ukvedadgenilia, ris gamoc Znelia iseTi 4 meore rigis medikamentisSerCeva, romlis mimarTac pacients eqneba mgrZnobeloba. Tu aRiniSnebarezistentoba meore rigis 2 an meti medikamentis mimarT (XDR-TB),maSin arCevis medikamentia moqsifloqsacini, misi maRalefeqturobisgamo (moqsifloqsacinsa da gatifloqsacins in-vitro axasiaTebT ufroZlieri tubsawinaaRmdego moqmedeba, vidre levofloqsacins,ofloqsacins da ciprofloqsacins.) 6 .Tumca mxedvelobaSi misaRebiameoradi efeqtebis riskic, mesame Taobis ftoroqinolonebis(moqsifloqsacini, gatifloqsacini) xangrZlivi tolerantoba ise araris Seswavlili, rogorc ofloqsacinisa da levofloqsacinis.SesaZloa gauTvaliswinebeli toqsiuri efeqtis ganviTareba, rogorces xdeba temafloqsacinis, trovafloqsacinis, sparfloqsacinisa dagrepafloqsacinis SemTxvevaSi. 7arsebobs jvaridini rezistentoba ciprofloqsacins, ofloqsacinsa dalevofloqsacins Soris, rac xasiaTdeba jgufuri efeqtiT.iSviaT SemTxvevaSi moqsifloqsacini emateba iseT reJims, sadac arisrezistentoba ofloqsacinis mimarT, magaliTad, rodesac aucilebeliareJimis Secvla da ar aris 2 medikamenti, rom Caanacvlos arsebulimkurnaloba.peroraluri baqteriostatikuri medikamentebi (IV jgufi)eTionamidi/proTionamidi; PAS iniSneba Cveulebriv dReSi orjer, TumcaSeiZleba miRebul iqnas dReSi erTxel. cikloserini umjobesia dReSiorjer, nevrologiuri garTulebebis ganviTarebis riskisSesamcireblad. mkurnaloba iwyeba cikloserinis, PAS daproTionamidis dabali dozebiT da momateba xdeba dagegmil dozebamde14 dRis ganmavlobaSi.SeniSvna: Tioacetazoni amJamad klasificirdeba, rogorc “jgufi 4”-is meorerigis medikamenti (janmo), igi kvlavac ar gamoiyeneba aiv dadebiT pacientebSida jgufi 4–is sxva medikamentebTan erTad, magram upiratesoba eniWeba mesamerigis medikamentebTan SedarebiT. 8I rigis ZiriTadi tubsawinaaRmdego medikamentebi (I jgufi)damatebiTi informacia E da Z gamoyenebis Sesaxeb:6 Francis J. Curry National Tuberculosis Center (CNTC),Drug-Resistant Tuberculosis. A Survival Guide for Clinicians (2004), M.D. Iseman. Tuberculosis therapy: past,present and future. Eur Respir J 2002; 20: Suppl. 36, 87s–94s,7 Rodriguez JC, Ruiz M, Climent A, Royo G. In vitro activity of four ftorquinolones against Mycobacterium tuberculosis. Int J Antimicrob Agents. 2001 Mar;17(3):229-31 ,M.D. Iseman8 Guidelines for the Pragmatic Management of Drug-Resistant Tuberculosis, WHO, 200615