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Int J Tuberc Lung Dis. 1998 Jan;2(1):10-5.

How drug resistance emerges as a result of poor compliance during short course chemotherapy for tuberculosis.

Author information

1
Department of Medical Microbiology, St. George's Hospital Medical School, London, UK. dmitchis@sghms.ac.uk

Abstract

OBJECTIVE:

To explore mechanisms by which drug resistance might arise as a result of poor compliance during short course chemotherapy.

DESIGN:

Four theoretical mechanisms are first described.

RESULTS:

Examples of the way the mechanisms probably operate are taken from: 1) a study of once-weekly chemotherapy with streptomycin and isoniazid, and 2) the pattern of drug susceptibility in cultures from patients who relapsed after the end of treatment.

CONCLUSION:

Good compliance is vitally important. The value of a fourth drug in the initial phase of chemotherapy in preventing resistance is questioned. An explanation for mono-resistance to rifampicin in patients with the acquired immune deficiency syndrome (AIDS) is suggested.

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PMID:
9562106
[Indexed for MEDLINE]

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