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  • Title: How drug resistance emerges as a result of poor compliance during short course chemotherapy for tuberculosis.
    Author: Mitchison DA.
    Journal: Int J Tuberc Lung Dis; 1998 Jan; 2(1):10-5. PubMed ID: 9562106.
    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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