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Correspondence
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Volume 359:2390-2391 November 27, 2008 Number 22
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Extensively Drug-Resistant Tuberculosis

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by Raviglione, M. C.
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by Mitnick, C. D.
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To the Editor: Mitnick and colleagues (Aug. 7 issue)1 have raised awareness about the clinical management and outcomes of extensively drug-resistant tuberculosis in Peru. Although a cure rate of 60% is encouraging, we caution against generalizing these findings to other high-burden settings. Of 95 patients with extensively drug-resistant tuberculosis (of whom about 60% were negative for the human immunodeficiency virus) we identified in Cape Town, South Africa, between 2006 and 2008, only 10% underwent culture conversion, despite intensive inpatient therapy, including capreomycin-based regimens. This difference may be due to higher rates of alcohol and drug abuse, smoking, and malnutrition among . . . [Full Text of this Article]



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