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Original Article
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Volume 334:1573-1576 June 13, 1996 Number 24
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Rifampin-Resistant Tuberculosis in a Patient Receiving Rifabutin Prophylaxis
William R. Bishai, M.D., Ph.D., Neil M.H. Graham, M.D., M.P.H., Susan Harrington, M.P.H., Christopher Page, B.A., Kristina Moore-Rice, R.N., B.S.N., Nancy Hooper, B.A., and Richard E. Chaisson, M.D.

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Drug-resistant tuberculosis has become a major public health problem in the United States.1,2 In 1979 less than 1 percent of tuberculosis isolates from untreated patients in New York City were resistant to rifampin, as compared with 9 percent in 1991.3 Rifampin-resistant tuberculosis is a serious threat because responses to therapy are more difficult to achieve and require longer courses of treatment.4,5,6,7,8

Rifabutin is a derivative of rifamycin S that is recommended and widely used as prophylaxis against Mycobacterium avium complex infection in patients infected with the human immunodeficiency virus (HIV) who have low CD4 lymphocyte counts.9,10 Since rifabutin was introduced . . . [Full Text of this Article]

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From the Departments of Molecular Microbiology and Immunology (W.R.B., C.P.) and Epidemiology (N.M.H.G., R.E.C.), Johns Hopkins University School of Hygiene and Public Health; the Departments of Medicine (W.R.B., R.E.C.) and Pathology (S.H.), Johns Hopkins University School of Medicine; the Baltimore City Health Department (K.M.-R.); and the Maryland Department of Health and Mental Hygiene (N.H.) — all in Baltimore.

Address reprint requests to Dr. Chaisson at Johns Hopkins University School of Medicine, Carnegie 292, 600 N. Wolfe St., Baltimore, MD 21287-6220.

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