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Bacterial resistance is the situation whereby at least 1% of the TB bacilli population is insensitive to one (mono-resistance) or more (multiple resistance) anti-tuberculosis drugs.

MDR-TB defines TB resistant to both INH and RMP.

Bacterial resistance may be primary or secondary. Primary resistance occurs when patients not previously treated with anti-TB drugs, become infected from a patient with resistant TB. Secondary resistance occurs when anti-tuberculosis chemotherapy is used improperly: mono-therapy, insufficient dosage of time of R/ and poor compliance. Drug resistance leads to R/ failures and disease recurrence. DOT (Directly Observed Treatment) is called for, when poor compliance is suspected.