결핵 진료지침 권고 요약(개정판) II. 결핵의 치료 1. 항결핵제
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Ⅱ. 결핵의 치료
결핵의 치료목적은
① 질환의 완치로 환자의 삶의 질 및 생산성을 회복시키는 것뿐만 아니라
② 활동성 결핵의 전염을 감소시키며
③ 결핵의 재발과 약제 내성의 발생 및 전차를 예방하는 것입니다.
1. 항결핵제
항결핵제의 분류
군(group) | 항결핵제 |
1군(경구용 일차 항결핵제) - 효과가 좋고 부작용이 적어서 초치료 시 선택되는 경구용 약제 | 이소니아지드(H) 리팜핀(R) 에캄부톨(E) 피라진아미드(P) 리파부틴(Rib) |
2군(주사제) - 효과가 좋으나 사용하기 불편하므로 약제내성이나 부작으로 일차 항결핵제를 사용할 수 없을 때 선택되는 약제 | 카나마이신(Km) 아미카신(Amk) 카르레오마이신(Cm) 스트렙토마이신(S) |
3군(퀴놀론계 약) - 항결핵효과가 좋으므로 결핵균의 감수성을 보일 때 이차 항결핵제로 선택되는 약제 | 레보플록사신(Lfx) 목시플록사신(Mfx) 오플록사신(Ofx) |
4군(경구용 이차 항결핵제) - 일차 항결핵제에 비해 항결핵 효과가 적고 부작용이 많아서 약제내성 결핵에서 이차 항결핵제로 선택되는 약제 | 프로치온아미드(Pto) 시클로세린(Cs) 파스(PAS) |
5군 - 약효가 입증되지 않아 표준 치료로 선택 되지 않고 내성결핵의 치료에서 적절한 약제 구성이 불가능한 경우 제한적으로 선택되는 약제들로 전문가 자문이 필요한 약제 | 클로파지민(Cfm) 리네졸리드(Lzd) Amoxixillin/Clavulnate 클래리스로마이신 고용량 이소니아지드 이미페넴 |
* 리파부틴은 항레스트로바이러스 약제를 사용 중인 HIV 감염인에서
결핵 초치료 시 선택됩니다.
고용량 이소니아지드는 16-20mg/kg/day입니다.
- 이전글결핵 진료지침 권고 요약(개정판) Ⅱ. 결핵의 치료 2. 결핵의 치료원칙 16.09.25
- 다음글결핵 진료지침 권고 요약(개정판) Ⅰ. 결핵의 진단 16.09.24
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