Subject(s)
Antitubercular Agents/pharmacology , Mycobacterium tuberculosis/drug effects , Aminosalicylic Acid/pharmacology , Czechoslovakia , Drug Resistance, Microbial , Humans , Isoniazid/pharmacology , Streptomycin/pharmacology , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/microbiologyABSTRACT
The value of anti-tuberculosis drugs for the treatment of infections caused by atypical mycobacteria is limited by the high prevalence of drug resistance. From the mycobacteriological point of view, however, nonspecific antibiotics and sulphonamides can also be used for their therapy. Atypical mycobacteria are high heterogeneous in their drug sensitivity patterns and in this respect each strain virtually represents a distinct biological unit. To select suitable drugs for combined treatment advantage should be taken of an analytical quantitative proportional sensitivity test that will allow determination of primary resistant population frequency per million viable mycobacterial units. In each case treatment should be with a combination of drugs in which the frequency of primary resistant populations is 10(-5) or lower.
Subject(s)
Anti-Bacterial Agents/pharmacology , Mycobacterium/drug effects , Nontuberculous Mycobacteria/drug effects , Sulfonamides/pharmacology , Antibiotics, Antitubercular/pharmacology , Drug Resistance, Microbial , Humans , Microbial Sensitivity Tests/methodsABSTRACT
Atypical mycobacteria are very often naturally resistant to antituberculosis drugs used in the therapy of tuberculosis. In contrast they are in vitro sensitive to some nonspecific antibiotics and sulfonamides. While the classical mycobacteria in their sensitivity to antituberculosis drugs are homogenous, atypical mycobacteria are very heterogenous. This heterogeneity occurs not only in different species, but inside of each species as well. For these reasons the therapy of mycobacterioses demands a deep analysis of the causative agent in the sense of its sensitivity using the analytic quantitative proportional sensitivity test. With this test it is possible to determine the frequency of the primary resistant population to one million viable mycobacterial units. In the therapy of mycobacterioses in comparison to tuberculosis and antituberculosis drugs does not exist any universal therapeutic regimen. The therapy of mycobacterioses needs a combined therapy including such therapeutic drugs as antituberculotics, nonspecific antibiotics, sulfonamides and antileprotics in which the frequency of primary resistant population will be lowest.
