The findings suggest that the activity of tuberculous inflammation is associated with different clinical forms of drug-resistant tuberculosis and with a spectrum of drug resistance.

Исследование проведено с целью оценки эффективности включения иммобилизованной пробиотической биологически активной добавки к пище «LB-комплекс Л» в диетотерапию при комплексном лечении больных туберкулезом легких� Изучена динамика изменений микробиоце-ноза толстой кишки у больных туберкулезом легких, в том числе с множественной лекарственной устойчивостью возбудителя в двух группах пациентов: получающих только базовую терапию и получающих базовую терапию и иммобилизованный пробиотик «LB-комплекс Л» как добавку к диете� Предложен алгоритм приема пробиотика с учетом фармакодинамики противотуберкулезных препаратов� Показана эффек-тивность использования предложенного алгоритма для профилактики формирования выраженных нарушений микробиоценоза, повышения приверженности пациентов к лечению, снижению частоты, тяжести и длительности побочных реакций на противотуберкулезные препараты� ключевые слова: туберкулез легких, микробиоценоз, дисбиоз, иммобилизованный пробиотик The study was conducted in order to evaluate the efficiency of adding immobilized probiotic biologically active food supplement of LB-Complex L to integral treatment of pulmonary tuberculosis� Changes of colon microorganism community in pulmonary tuberculosis patients including those with multiple drug resistance were studied in two groups of patients: receiving only basic treatment and basic treatment with the immobolized probiotic of LB-Complex L as a food supplement� The algorithm of probiotic intake has been offered with the consideration of pharmacodynamics of anti-tuberculosis drugs� The offered algorithm proved to be effective for prevention of disorders in microorganism community, enhancement of adherence to treatment, reduction of frequency, severity and duration of side effects to anti-tuberculosis drugs�

No abstract

The purpose of this research was to determine the dependence of the tubercular inflammation activity of varying duration of the disease and drug resistance. Morphological activity of inflammation in 161 patients with drug-resistant and 149 patients with retaining its high sensitivity was studied. Morphological assessment of the activity of specific changes in tuberculosis was carried out according to the B.M. Ariel classification (1998). It was revealed at morphologic study of resection material that the greatest activity of specific inflammation and its prevalence outside the main lesion was in the group of patients limited with drug resistance tuberculosis. It was noted the prevalence of IV-V degree of morphological activity of tubercular process in the study group by 3 times over the control group with disease duration of more than 1 year. Predominance of widespread active specific changes (IV degree) was determined in 2 times for the first educed patients of basic group with drug-resistant above a control group. This is due to increasing the number of patients with cavernous and fibro-cavernous tuberculosis.Thus, it is necessary to operate patients with drug-resistant tuberculosis as soon as possi-ble after adequate specific therapy and the presence of the signs of stabilization process, because as the full stabilization of tuberculosis process did not achieve according to the morphological study of surgical specimens in the preoperative period. Further specific therapy becomes futile due to the rise of drug resistance, the emer-gence of new drug-resistant strains of Mycobacterium tuberculosis.

Tuberculosis (TB) remains a global problem up to this day. Against the background of the successes achieved in the fight against this infection, many problems have not yet been fully solved. These problems include drug resistance of the pathogen, comorbidity and multimorbidity of TB, the search for new types of drugs, the management and prevention of undesirable side effects of long­term chemotherapy, etc. These problems can only be solved through collaboration between health care professionals and patients. Timely abacillation, closing of decay cavities and stabilization of the clinical condition are practically impossible without such cooperation. Therefore, an important task of phthisiology is to stabilize the patient’s adherence to anti­TB therapy throughout the course of treatment.The aim of the review is to describe existing and innovative ways to improve the level of adherence of TB patients to anti­TB therapy.Conclusion. Current methods to improve adherence of TB patients, both in Russia and other countries, need to be improved and adequately funded. Additive technologies that more effectively reduce the risks of unmotivated discontinuation of polychemotherapy may be the solution.