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KMID : 0882420080750020141
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Korean Journal of Medicine
2008 Volume.75 No. 2 p.141 ~ p.148
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Treatment of pulmonary tuberculosis in elderly
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Park Jae-Seuk
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Abstract
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Although the incidence of tuberculosis has declined dramatically recently, tuberculosis is still one of the great public
health problems in South Korea. Older persons are more susceptible to tuberculosis than younger persons. Older
pulmonary tuberculosis patients may have few symptoms and atypical radiographic findings, so clinicians need to have
high index of suspicion to make a diagnosis of pulmonary tuberculosis. The basic approach to treatment of tuberculosis
in elderly is the same as in younger patients. Standard chemotherapy of drug susceptible tuberculosis consists of a
2-months intensive phase (isoniazid, rifampin, ethambutol, pyrazinamide) followed by 4-months maintenance phase
(isoniazid, rifampin, ethambutol). Vitamin B6 (pyridoxine) is usually given to prevent isoniazid induced peripheral
neuropathy which is more common in elderly patients. Older tuberculosis patients are more susceptible to adverse effects
of anti-tuberculosis drugs. Monitor liver function and educate elderly patients and their family members about the signs
and symptoms of adverse drug reactions and encourage to report promptly to their physician any of adverse drug
reactions. Compliance to treatment of elderly tuberculosis patients is poor due to frequent co-morbid conditions and low
socioeconomic conditions. Public-private collaboration will improve the compliance of elderly tuberculosis patients
managed in private hospitals. (Korean J Med 75:141-148, 2008)
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KEYWORD
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Elderly, Tuberculosis, Treatment
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