Multi-Drug Resistant Tuberculosis. Peter D.O. Davies
Director of the Tuberculosis Research Unit, Cardiothoracic Centre, Thomas Drive, Liverpool L14 3PE.
Received March 1999
Return to Journal Contents Key words Tuberculosis, drug resistance,
Isoniazid, Rifampicin, relapse Introduction Before the discovery of specific antibiotics for the treatment of tuberculosis, there was no cure. Mortality of those with pulmonary disease (disease of the lungs) was about 50%. The introduction of anti-tuberculosis drugs in the 1950s and the development of the various drug regimens meant that by the 1980s there was a 98% chance of cure. However, treatment had to be continued with good quality drugs for as long six months to ensure cure. The difficulties in ensuring this occurs, especially in resource poor countries, has resulted in an increasing incidence of tubercle bacteria resistant to the most effective drugs; so called multi-drug resistant tuberculosis. The historical background The end of the sanatorium movement. In the second half of the 19 th century, a new movement for the treatment of tuberculosis came into existence; the sanatoria. These were something of a cross between a hotel and a hospital where tuberculosis patients would come and spend many months or even years. Treatment was a combination of sunlight, diet and gentle exercise. It is doubtful whether the sanatoria improved survival of the patients but may have reduced tuberculosis in the community by removing infectious patients, so reducing transmission. | |
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