3.10 : 结核病 V- 协作护理

Collaborative care for pulmonary tuberculosis involves a prolonged medication course tailored to drug-susceptible or drug-resistant tuberculosis.

Drug-susceptible tuberculosis refers to strains of tuberculosis that are sensitive to the standard first-line anti-tuberculosis drugs, like Isoniazid, Rifampin, Pyrazinamide, and Ethambutol.

These drugs are administered in combination orally once a day for eight weeks during the initial phase.

The continuation phase of treatment then includes Isoniazid and Rifampin for four or seven months.

In contrast, drug-resistant tuberculosis occurs when the patient becomes resistant to at least one of the first-line drugs, often due to incorrect dosage or premature treatment termination. It requires second-line drugs such as Fluoroquinolones.

Directly Observed Therapy or DOT is the preferred strategy to ensure all patients take their medications promptly, where a designated person observes the patient swalloing the medication to prevent nonadherence and multidrug resistance.

Finally, continuous patient monitoring, including monthly assessments of sputum culture, liver enzymes, creatinine, and blood urea nitrogen, is necessary to evaluate treatment effectiveness.