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Drug-resistant Mycobacterium tuberculosis in Korean isolates.

J L Carpenter, H D Covelli, M E Avant

    The American Review of Respiratory Disease
    |December 1, 1982
    PubMed
    Summary

    Multidrug-resistant tuberculosis is rising in Korea. Initial treatment with isoniazid, ethambutol, and rifampin may fail due to increasing resistance, necessitating alternative drug regimens.

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    Area of Science:

    • Infectious Diseases
    • Microbiology
    • Public Health

    Background:

    • Tuberculosis (TB) is a significant global health challenge, particularly in developing nations.
    • Rising resistance to first-line anti-TB drugs like isoniazid (INH) and streptomycin is a growing concern, especially in the Far East.
    • Current guidelines recommend empirical treatment with INH, ethambutol, and rifampin for TB patients from this region.

    Purpose of the Study:

    • To investigate the prevalence of drug resistance in Korean Mycobacterium tuberculosis isolates.
    • To assess the potential for emerging resistance to ethambutol and rifampin in addition to INH and streptomycin.
    • To inform optimal initial therapeutic strategies for TB patients in Korea.

    Main Methods:

    • Analysis of drug susceptibility testing data from Mycobacterium tuberculosis isolates obtained from Korean patients.

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  • Evaluation of resistance patterns to isoniazid, streptomycin, ethambutol, and rifampin.
  • Review of clinical experience and in vitro sensitivity data.

    • Main Results:

    • A significant increase in resistance to isoniazid and streptomycin was observed in Korean TB isolates.
    • Emerging resistance to ethambutol and rifampin was also documented in these isolates.
    • A substantial proportion of isolates exhibited multidrug resistance, challenging standard empirical regimens.

    Conclusions:

    • Empirical use of isoniazid, ethambutol, and rifampin may be inadequate for treating TB in Korea due to rising resistance.
    • Multidrug resistance poses a significant threat, potentially rendering common initial therapies ineffective.
    • A treatment regimen including isoniazid, rifampin, pyrazinamide, and capreomycin is proposed as a more appropriate initial therapy based on current resistance data.