소개글
[감염학] 결핵 치료에서의 steroid에 대한 자료입니다.
목차
1. 치료 반응 평가
2. 투여용량과 기간
3. BBB 통과
4. Side effect
본문내용
Wikipidia
Herrison’s international medicine, fauci
Cecil medicine 23th edition, goldman& ausiello
POWER manual series 18th edition
이 환자는 결핵성 수막염(Tuberculous meningitis)로 추정
치료
1. BBB를 통과하는 항결핵제와
: isoniazid, rifampicin, pyrazinamide and ethambutol for two months, followed by isoniazid and rifampicin alone for a further ten months
2. 스테로이드(dexamethasone)을 병용
: Steroids are always used in the first six weeks of treatment (and sometimes for longer)
Pleurisy(흉막염): prednisolone 20 to 40 mg daily tapered off over 4 to 8 weeks
Extremely advanced TB: 40 to 60 mg daily tapered off over 4 to 8 weeks
TB in children: 2 to 5 mg/kg/day for one week, 1 mg/kg/day the next week, then tapered off over 5 weeks
Steroids may be of benefit in peritonitis, miliary disease, laryngeal TB, lymphadenitis and genitourinary disease
routine use of steroids cannot be recommended.
-> should be considered by the attending physician.
Thalidomide may be of benefit in TB meningitis and has been used in cases where patients have failed to respond to steroid treatment