氯法齐明治疗肺结核效果怎么样?

Clofazimine is a high-grade antibiotic suitable for the treatment of multi-drug-resistant pulmonary tuberculosis, which requires combination with a variety of sensitive and effective anti-tuberculosis drugs.

A randomized multicenter study to investigate whether clofazimine improves the efficacy of a standardized regimen in patients with multidrug-resistant tuberculosis (MDR-TB).

MDR-TB patients receiving treatment at 17 TB specialist hospitals in China were randomly divided into two groups. In the intervention group, 100 mg of clofazimine was added daily to the standardized regimen. The primary outcome was the proportion of patients who achieved success.

Results: Of the 156 patients screened, 74 were assigned to the control group and 66 to the group. In the clinical outcome analysis of 66 patients in the clofazimine group, 36 patients were cured and 7 completed treatment, yielding a good outcome rate of 65.1%. The proportion of patients with good results who received the control regimen was 47.3% (35/74), which was significantly lower than that in the clofazimine group (p 0.034, relative risk 0.661, 95% CI 0.243-0.949).

Conclusions: The addition of clofazimine to standard regimens improves the treatment of multidrug-resistant tuberculosis.

A prospective, randomized, controlled study was conducted on patients with multidrug-resistant tuberculosis, who were treated for 18 months. Patients in the experimental group received bedaquiline and clofazimine in addition to their usual treatment regimen, while patients in the control group did not.

Results: 68 patients with multidrug-resistant tuberculosis were randomly treated, 34 in each group. At the end of treatment, the experimental group had a statistically significantly higher cure rate compared to the control group (82% vs. 56%). There was no difference in the number of severe cases (3 [9%]) between the two groups, and none were skin related.

Conclusions: Adding bedaquiline and clofazimine to treatment regimens significantly improves outcomes in patients with MDR-TB.

Clofazimine is another core second-line drug that can be used to treat pulmonary tuberculosis, but it is not a drug in the conventional treatment plan, but is used to treat multi-drug-resistant tuberculosis. There are certain difficulties in the treatment of drug-resistant tuberculosis. According to the degree of drug resistance, it can be divided into several levels: mono-drug resistance, multi-drug resistance, multi-drug resistance and extensive drug resistance. The treatment course of drug-resistant tuberculosis must be significantly extended. Clofazimine is used for drug-resistant tuberculosis and non-tuberculous mycobacteriosis, 100 mg three times a day, in combination with anti-tuberculosis drugs. It is recommended to take medication according to the doctor's instructions and treat symptoms accordingly.

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References

[1.]Duan H, Chen tuberculosis: a randomized controlled trial. Clin Microbiol Infect. 2019 Feb;25(2):190-195. doi: 10.1016/j.cmi.2018.07.012. Epub 2018 Jul 21. PMID: 30036672.

[2]Yao G, Zhu M, Nie Q, Chen N, Tu S, Zhou Y, Xiao F, Liu Y, Li X, Chen H. Improved outcomes following addition of bedaquiline and clofazimine to a treatment regimen for multidrug-resistant tuberculosis. J Int Med Res. 2023 Jan;51(1):3000605221148416. doi: 10.1177/03000605221148416. PMID: 36719280; PMCID: PMC9893081.