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Drug-resistant Mycobacterium tuberculosis in Korean isolates
The American Review of Respiratory Disease
|December 1, 1982
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.
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.
- 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.