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January 5, 2000

Global Action Against Multidrug-Resistant Tuberculosis—Reply

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(1):54-55. doi:10-1001/pubs.JAMA-ISSN-0098-7484-283-1-jbk0500

In Reply: In response to Dr Schraufnagel and Abubaker, we would first emphasize that MDRTB, defined as resistance to at least isoniazid and rifampin, is not synonymous with drug-resistant TB. MDRTB can persist and even increase in areas that use the currently recommended treatment protocol, DOTS.

Approximately 15 years of short-course chemotherapy in the setting of a national program produced impressive declines in the overall prevalence of drug-resistant TB in Korea.1 The prevalence of MDRTB, however, was 1.7% in 1980 and 5.3% in 1995.1 The rifampin-based short-course treatment regimens remain reasonably effective for drug-resistant TB that is susceptible to rifampin and other first-line agents.1 These regimens are ineffective treatments for MDRTB.2 Because standard short-course treatments are ineffective, one national TB referral hospital in Korea changed to individualized regimens based on drug sensitivity testing to treat patients with MDRTB.3

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