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Previous Volume 329:784-791 September 9, 1993 Number 11 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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The era of modern, predictably effective tuberculosis chemotherapy began in 1952. Since then, strains of Mycobacterium tuberculosis have acquired resistance to various drugs, thus compromising both treatment and control programs. Most ominously, the rising prevalence of multidrug-resistant strains (defined here as M. tuberculosis resistant to isoniazid and rifampin, with or without resistance to other drugs) has resulted in many cases of marginally treatable, often fatal, disease. The care of patients with documented multidrug-resistant tuberculosis will be the focus of this report. I shall also examine briefly the origins, biologic mechanisms, and epidemiology of drug resistance, its impact on the outcome . . . [Full Text of this Article]

Inadequate Treatment Programs and Acquired Drug Resistance

Biologic Mechanisms of Resistance

Current Epidemiology of Resistance

Effects of Drug Resistance on Treatment Outcome

HIV-Negative Patients

Patients with HIV Infection or AIDS

Implications of Multidrug Resistance for Initial Therapy

Combined Formulations

Treatment of Patients with Proved Multidrug-Resistant Tuberculosis

Initiation of Retreatment

Drugs Used in Retreatment Regimens

Monitoring Retreatment

The Role of Resectional Surgery

Prevention of Tuberculosis in the Contacts of Patients with Multidrug-Resistant Tuberculosis

Summary

Source Information

From the Department of Medicine, Division of Infectious Diseases, National Jewish Center for Immunology and Respiratory Medicine, 1400 Jackson St. -- J 201 Annex Bldg., Denver, CO 80206, where reprint requests should be addressed to Dr. Iseman.

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