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Treatment of multidrug-resistant tuberculosis

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Multidrug-resistant Tuberculosis

Part of the book series: Resurgent and Emerging Infectious Diseases ((REID,volume 1))

Abstract

The modern era of effective tuberculosis chemotherapy began in 1952. Since then, strains of Mycobacterium tuberculosis have acquired resistance to various drugs. The rising prevalence of multidrug-resistant strains (resistant to isoniazid and rifampicin, with or without resistance to other drugs) is most ominous and has resulted in many cases of marginally treatable, often fatal, disease. The World Health Organization (WHO) noted in 1997 that not only is tuberculosis a global emergency, but that several “hot spots” exist where multidrug-resistant tuberculosis (MDRTB) prevalence is so high that control programs are threatened [1]. These “hot spots”, in conjunction with rising HIV prevalence, pose a serious threat to tuberculosis control programs. Many still consider MDRTB a focal problem that need not be addressed on a global scale. The contrary view, eloquently stated by Farmer et al, is that “... in choosing to ignore MDRTB as a global priority, we are setting our sights too low. Unambitious goals will insure millions of deaths and the persistence, in the human population, of resistant M. tuberculosis ” [2]. In this chapter we will focus on the care of patients with MDRTB as well as examine the origins, biologic mechanisms, and epidemiology of drug resistance, its impact on the outcome of therapy, and the implications of MDR-TB for standard initial therapeutic regimens.

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Authors and Affiliations

  1. National Jewish Medical and Research Center, Denver, Colorado, USA

    Michael D. Iseman & Gwen A. Huitt

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  1. Michael D. Iseman
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  2. Gwen A. Huitt
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Editors and Affiliations

  1. Mycobacterium Reference Laboratory, Institute of Medical & Veterinary Science, Adelaide, Australia

    Ivan Bastian

  2. Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium

    Françoise Portaels

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Iseman, M.D., Huitt, G.A. (2000). Treatment of multidrug-resistant tuberculosis. In: Bastian, I., Portaels, F. (eds) Multidrug-resistant Tuberculosis. Resurgent and Emerging Infectious Diseases, vol 1. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-4084-3_11

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  • DOI: https://doi.org/10.1007/978-94-011-4084-3_11

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-5794-3

  • Online ISBN: 978-94-011-4084-3

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