RT Journal Article
SR Electronic
T1 The challenge of drug-resistant tuberculosis
JF Cleveland Clinic Journal of Medicine
JO Cleve Clin J Med
FD Cleveland Clinic
SP 431
OP 437
VO 61
IS 6
A1 Lee B. Reichman
YR 1994
UL http://www.ccjm.org/content/61/6/431.abstract
AB CLINICAL ISSUES After declining for decades, the incidence of tuberculosis is again increasing, and strains resistant to multiple drugs are appearing. The greatest increases in infection have been in blacks and Hispanics. The disease is most aggressive in patients infected with human immunodeficiency virus and in patients receiving immunosuppressive therapy; diagnosis may be difficult in these groups. Resistance to antituberculosis drugs is the result of inadequate regimens or of patients not complying with prescribed regimens.RECOMMENDATIONS The current epidemic can be stopped, but this will require a serious commitment by the public, the medical community, government, and industry. Physicians must prevent the spread of tuberculosis, detect people who are infected, treat infected people preventively with isoniazid, and, in people with active disease, rapidly establish the diagnosis and use adequate, directly supervised, four-drug regimens to treat it. Convenient combined preparations and programs to directly supervise the taking of medications are needed.