항결핵제를 유지하면서 치료한 항결핵제 유발 위막성 대장염 치험 1예

• Published in: Taehan Sohwagi Naesigyŏng Hakhoe chi Vol. 38; no. 1; pp. 47 - 51
• Main Authors: 우명렬, Myoung Lyeol Woo, 조재희, Jae Hee Cho, 김정훈, Jeong Hun Kim, 김명환, Myoung Hwan Kim, 권혁진, Hyuk Jin Kwon, 왕길상, Kil Sang Wang, 이상엽, Sang Yeop Yi, 조현근, Hyeon Geun Cho
• Format: Journal Article
• Language: Korean
• Published: 대한소화기내시경학회 30.01.2009
• Subjects: Anti- tuberculosis agents; PMC; Pseudomembranous colitis; 위막성 대장염; 항결핵제
• ISSN: 1225-7001

항결핵제에 의한 위막성 대장염은 항결핵제에 내성을 획득한 C. difficile에 의해 유발될 수 있다. 일반적으로 위막성 대장염은 대증적 치료 외에 원인 약물을 중단하고 경구metronidazole이나 vancomycin 등을 사용하여 치료한다. 하지만 항결핵제 유발 위막성 대장염에서 항결핵제를 유지하면서 경구 metronidazole을 사용하여 위막성 대장염을 치료한 사례는 보고되지 않아, 저자들은 항결핵제를 유지하면서 치료한 위막성 장염 1예를 보고하는 바이다. Tuberculosis is one of the main infectious health problems in Korea, and a combination of antibiotics is required to treat this illness. The combination therapy with rifampicin, isoniazid, ethambutol and pyrazinamide has many adverse reactions and there have been several case reports about pseudomembranous colitis (PMC) after anti-tuberculosis treatment. Rifampicin is regarded as a main cause of anti-tuberculosis induced PMC because of its bacteriocidal effect, and interruption of the offending drug, such as rifampicin, is usually necessary to treat the PMC. However, in patents with uncompensated tuberculosis, the discontinuance of anti-tuberculosis medication accentuates the disease severity, and continuance of the anti-tuberculosis medication is necessary to overcome the tuberculosis. We report here on a case in which the anti-tuberculosis agents induced PMC in 32 year old female who was diagnosed with active pulmonary tuberculosis. She was treated with maintenance of the anti-tuberculosis medication and also the addition of both oral metronidazole and probiotics. (Korean J Gastrointest Endosc 2009;38:47-51)