How drug resistance emerges as a result of poor compliance during short course chemotherapy for tuberculosis. NLM AIDSLINE Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.

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

Int J Tuberc Lung Dis. 1998 Jan;2(1):10-5. Unique Identifier : AIDSLINE MED/98220574
Mitchison DA; 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.
Keywords: *Antitubercular Agents/THERAPEUTIC USE *Patient Compliance *Tuberculosis, Multidrug-Resistant/ETIOLOGY *Tuberculosis, Pulmonary/DRUG THERAPYKWDantitubercularagents/therapeuticuseKWDpatientcomplianceKWDtuberculosis,multidrug-resistant/etiologyKWDtuberculosis,pulmonary/drugtherapy
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