Pidverbetska О. Regimens of antituberculous and pathogenic therapy in patients with pulmonary tuberculosis with violations of microbiocenosis and adsorptive function of the intestine

Object of the study: newly diagnosed pulmonary tuberculosis (NDTB) with remained sensitivity, multidrug-resistant TB (MDR-TB), co-infection HIV-TB; objective - to improve anti-tuberculosis and pathogenetic therapy in patients with pulmonary tuberculosis (TB) by taking into account the state of the small intestine absorptivity and microbiocenosis of the large intestine; methods: general clinical, biochemical, microbiological, molecular genetic, immunological, immuno-enzymatic, instrumental, radiological, general and special histochemical and morphometric, statistical ones; novelty: it has been proved for the first time that 58,9 % of patients with NDTB, 76,1 % of those with MDR-TB and 78,6 % of individuls with HIV-TB experienced a reduced absorptivity of the small intestine 93,2 % of patiens with drug-sensitive NDTB and all patients with MDR-TB as well as those with co-infection HIV-TB had the large intestine dysbiosis which was found before the antibacterial therapy according to a correspondent category and which affect the clinical course of TB negatively; for the first time morphological changes of the small intestine, which are the basis for disorders in the adsorption of anti-tuberculosis drugs, and morphological changes of the large intestine that develop as a result of dysbiosis, have been studied; the expediency of using isoniazid, rifampicin and ethambutol parenterally in patients with drug-sensitive NDTB, injection forms of fluoroquinolones in patients with MDR-TB with moderate and severe impairment of absorption in the small intestine against the background of correction of dysbiotic disorders of the large intestine is substantiated, which allows to increase the frequency of bacterial excretion reliably by 26,7 % in NDTB and by 21,2 % in MDR-TB. The field of application is medicine.