[Therapy of tuberculosis today: to prescribe is not enough. A case report]

Tuberculosis is a re-emerging disease not only in developing but also in industrialized countries. The multidrug resistance of Mycobacterium tuberculosis is an increasing problem, mainly due to the poor compliance of the patients on drug regimens. The authors discuss the case of a 28-year-old male affected by pulmonary tuberculosis who did not improve after a 3-month period of oral tuberculosis treatment. The switch to intravenous therapy was rapidly followed by clinical and microbiological improvement. The patient subsequently admitted that he had not complied with oral treatment because after healing he would be sent back to prison. This case demonstrates that, even in the hospital setting, noncompliance to antitubercular therapy is not unfrequent, as demonstrated by other case reports. The authors discuss a great amount of literature that strongly supports the introduction of directly observed therapy for the treatment of all tuberculosis patients.