에탐부톨

경구용 항마이코박테리아 항생제

에탐부톨은 합성 정균성 항마이코박테리아 약물로, 주로 다제 병용 요법('칵테일 요법')의 일부로 사용되어 난치성 마이코박테리아 감염(결핵균, 소결핵균, 조류형 결핵균 복합체 등)을 치료합니다. **임상적 진주:** 단계적 내성 발현을 방지하기 위해 단독 요법은 엄격히 금지됩니다. 일반적으로 리팜핀, 이소니아지드 등의 약물과 병용합니다. > **중요한 공중 보건 주의사항:** 인수공통감염의 심각한 잠재적 위험성, 특히 가정 내 면역 저하자에게 미치는 위험 때문에 수의학에서 이러한 감염을 치료하는 것은 논란의 여지가 많습니다.

작용 기전: Ethambutol is active only against actively dividing mycobacteria. Mechanistically, it inhibits the enzyme **arabinosyl transferase** → disrupts the synthesis of arabinogalactan → prevents the incorporation of **mycolic acid** into the mycobacterial cell wall. This disruption increases cell wall permeability, which allows other antimycobacterial drugs (like rifampin or isoniazid) to penetrate the cell more effectively. It also interferes with RNA synthesis. It has no appreciable activity against other non-mycobacterial bacteria or fungi.

동물 종별 용량

Cats

Treatment of feline tuberculosis (resistant cases) · 15 mg/kg PO once daily · PO · once daily · Not specified · Considered if resistance develops to initial therapy. Used in combination with rifampin and isoniazid.

Birds

Treatment of M. avium infections in caged birds (Protocol 1) · 20 mg/kg PO q12h · PO · q12h · 6-12 months · Used with Ciprofloxacin/Enrofloxacin, Clofazimine, and Cycloserine.
Treatment of M. avium infections in caged birds (Protocol 2) · 30 mg/kg PO once daily · PO · once daily · 6-12 months · Used with Clofazimine and Rifampin.
Treatment of M. avium infections in caged birds (Protocol 3) · 30 mg/kg PO once daily · PO · once daily · 6-12 months · Used with Ciprofloxacin/Enrofloxacin and Rifampin/Rifabutin.
Avian mycobacteriosis · 30-85 mg/kg PO once daily · PO · once daily · 9-12 months · Used with Rifabutin, Clarithromycin, and Enrofloxacin.

Dogs

Treatment of disseminated M. tuberculosis · 10-25 mg/kg PO once daily · PO · once daily · More than 9 months · Used in combination with rifampin (5-10 mg/kg PO q12-24h) and isoniazid (10-20 mg/kg PO once daily). May also add pyrazinamide (ineffective for M. bovis).

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

금기

Patients with a history of prior hypersensitivity reactions to ethambutol

이상반응

Optic neuritis (decreased visual acuity, usually reversible)
CNS degenerative changes (with prolonged use)
Myocardial toxicity (at high doses)
Depigmentation of the tapetum lucidum
Bacterial or fungal overgrowth (due to prolonged multi-drug antimicrobial therapy)

약물 상호작용

Aluminum-containing antacids · Can reduce oral absorption of ethambutol; separate dosing by at least 4 hours if both are necessary

모니터링

Clinical efficacy
Visual function (periodic monitoring with long-term therapy)
Liver function
Renal function
CBC
Monitor for fungal or bacterial overgrowth infections

과용량

Very limited veterinary information exists. In humans, acute overdoses of >10 grams have caused **optic neuritis**. Other adverse effects noted with human overdoses include CNS effects (confusion, visual hallucinations), abdominal pain, nausea, fever, and headache. Treatment is supportive.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.