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n Suid-Afrikaanse Tydskrif vir Natuurwetenskap en Tegnologie - 'n Oorsig van die bepaling van die vroeë bakterisidiese aktiwiteit van verskeie antituberkulosemiddels : research and review article

Volume 22, Issue 2_3
  • ISSN : 0254-3486
  • E-ISSN: 2222-4173

Abstract

Die vroeë bakterisidiese aktiwiteit (VBA) van 'n antituberkulosemiddel is die daaglikse afname van M tuberculosis in log<sub>10</sub> kolonievormende eenhede per ml sputum, tydens die eerste twee dae van behandeling met die middel. Dit weerspieël die vermoë van 'n middel om aktief metaboliserende organismes in tuberkulose-longholtes te dood. Dit is 'n relatief goedkoop metode om in 'n klein groep pasiënte die antituberkulose-aktiwiteit van 'n middel, binne maande, <b>in vivo&lt;/b&gt; te evalueer. Hierdie artikel som ons ondervinding op tydens sewe gepubliseerde VBA-studies, en die bronne van variasie in die prosedure word identifiseer. Die pasiënte in hierdie studies was gemiddeld 33 jaar oud, met 'n gemiddelde gewig van 50 kg en 55% het ekstensiewe of massiewe longaantasting gehad. Die hoogste VBA-waardes (0, 50-0, 66) is gevind in pasiënte wat isoniasied ontvang het, en die laagste waardes (0, 05 en 0, 09 respektiewelik) was gevind in pasiënte wat die aminoglikosiede amikasien en paromomisien, albei in doserings van 15 mg/kg liggaamsgewig, ontvang het. Die algehele variasie in die VBA van 248 pasiënte was 0, 0312, en die variasie toegeskryf aan die proses van sputumproduksie en -versameling was 0, 0223. Dit blyk dat die verskillende aspekte van sputumproduksie en -versameling, betrokke by die lewering van 'n verteenwoordigende sputummonster, 'n groter bydrae maak tot variasie tydens die prosedure as die laboratoriumaspekte van die tegniek. Die keuring van pasiënte vir insluiting in VBA-studies, en hulle vermoë om saam te werk om 'n verteenwoordigende sputummonster te produseer, is van deurslaggewende belang in die suksesvolle voltooiing van VBA-studies.

<b>A review of the determination of the early bactericidal activity of various antituberculosis agents</b> The early bactericidal activity (EBA) of an antituberculosis agent is the daily decline in log&lt;sub&gt;10&lt;/sub&gt; colony forming units of M tuberculosis per ml of sputum during the first two days of treatment with the agent. It reflects the capacity of an agent to kill the actively metabolising organisms in tuberculosis lung cavities. It offers a relatively cheap means to evaluate the antituberculosis activity of an agent in a small group of patients within a matter of months. This article summarizes the authors' experience in seven published EBA studies and identifies sources of variation in the procedure. The patients who participated in these studies had a mean age of 33 years, a mean weight of 50 kg and there was extensive or massive involvement of the lungs in 55% of patients. The highest EBA values (0, 50-0, 66) were found in groups of patients receiving isoniazid and the lowest values (0, 05 and 0, 09 respectively), in patients receiving the aminoglycosides amikacin and paromomycin in a dose of 15 mg/kg body weight. The variation in EBA in 248 patients was 0, 0312 and the variation ascribable to the process of sputum production and collection was 0, 0233. This implies that the different aspects of sputum production and collection involved in obtaining a representative sputum sample are responsible for most of the variation in EBA results. The selection of patients for inclusion in EBA studies and their ability to co-operate in producing a representative sputum specimen are of critical importance in the successful completion of EBA studies.

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/content/aknat/22/2_3/EJC20329
2003-06-01
2019-08-17

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