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Fortschritte in der Therapie der Tuberkulose

Progress in the therapy of tuberculosis

  • Leitthema
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Zusammenfassung

Die weltweit zunehmenden Medikamentenresistenzen und der damit verbundene schlechtere Behandlungserfolg bei komplex-resistenten Fällen stellen derzeit eine der größten Herausforderungen in der Tuberkulosetherapie dar. Die Entwicklung neuer Therapien ist ein entscheidender Baustein zur Verbesserung des Behandlungserfolgs und somit zur Kontrolle der Tuberkulose. In den letzten Jahren gab es auf diesem Gebiet einige vielversprechende Neuentwicklungen, aber auch Wiederentdeckungen altbekannter Medikamente wie Linezolid und Isoniazid. Eine Auswahl von neuen Medikamenten wie Delamanid, PA-824, Bedaquilin und Rifapentin sollen in dieser Arbeit ebenso vorgestellt werden wie neue adjuvante Therapieansätze (Vitamin D, Vitamin C und Verapamil). Abschließend soll der aktuelle Stellenwert chirurgischer Maßnahmen in der Tuberkulosetherapie vor dem Hintergrund der Resistenzproblematik dargestellt werden.

Abstract

From a global perspective, one of the key topics in the field of tuberculosis is the rising incidence of drug resistance and the associated decrease in treatment success. The development of new drugs is of great importance for the improvement of treatment success and subsequently for tuberculosis control. The developments of the recent years have brought some promising new tuberculosis drugs. Additionally, the effectiveness of established drugs, such as linezolid and isoniazid, has been shown in combination therapies. In this article some of the new developments in drug therapy, including delamanid, pa-824, bedaquiline and rifapentine, along with promising adjuvant therapies, such as vitamin D, vitamin C and verapamil will be reviewed. Furthermore, the current role of surgical interventions in tuberculosis therapy will be discussed against the background of a rising drug resistance problem.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. R. Otto-Knapp und L. Bös geben an, dass kein Interessenkonflikt besteht. T. Schaberg berät Otzuka (Delamanid). Alle im vorliegenden Manuskript beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Authors and Affiliations

  1. Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Deutschland

    R. Otto-Knapp

  2. Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose (DZK), Walterhöferstr. 11, 14165, Berlin, Deutschland

    R. Otto-Knapp & L. Bös

  3. Zentrum für Pneumologie, Agaplesion Diakonieklinikum Rotenburg, Elise-Averdiek-Str. 17, 27356, Rotenburg, Deutschland

    T. Schaberg

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  1. R. Otto-Knapp
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  2. L. Bös
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  3. T. Schaberg
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Correspondence to R. Otto-Knapp or T. Schaberg.

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Otto-Knapp, R., Bös, L. & Schaberg, T. Fortschritte in der Therapie der Tuberkulose. Pneumologe 11, 34–41 (2014). https://doi.org/10.1007/s10405-013-0696-1

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