How drug resistance emerges as a result of poor compliance during short course chemotherapy for tuberculosis [Counterpoint]
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.
Document Type: Miscellaneous
Affiliations: Department of Medical Microbiology, St. George's Hospital Medical School, London, UK
Publication date: January 1, 1998
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