Treatment of tuberculosis in Australia

The combination of isoniazid and rifampicin, initially accompanied by a third drug such as ethambutol, has become the standard treatment for pulmonary tuberculosis in Australia. Not all patients need admission to hospital but careful follow-up and encouragement of compliance with the regimen is important during the year of therapy which follows the diagnosis of the disease. Because of the higher incidence of drug resistance in disease acquired in Southeast Asia, a fourth drug, usually pyrazinamide, is added until the results of sensitivity testing are known. Pulmonary disease caused by environmental ("atypical") mycobacteria presents special problems in treatment because the infection usually complicates pre-existing lung disease; drug resistance is the rule; and there are no well controlled prospective trials to provide a rational basis for therapy.