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Multidrug-resistant tuberculosis (MDR-TB) occurs when the
bacteria are resistant to at least isoniazid and rifampin. This means that
these medicines are unable to kill the bacteria. The reasons
antibiotic resistance occurs include:
People who have resistant disease are at increased risk
for dying of TB, especially if they also are infected with the
human immunodeficiency virus (HIV). People who are at
highest risk for developing multidrug-resistant TB are those who:
To reduce the problem of drug resistance, doctors now use the
following guidelines to treat all people who have resistant TB:1
A rare type of MDR-TB is called extensively drug-resistant
tuberculosis (XDR-TB). This type of TB is resistant to isoniazid, rifampin, and
several other medicines used to treat TB. And some TB bacteria have become resistant to all of the antibiotics commonly used to treat TB. This is sometimes called totally resistant tuberculosis (TDR-TB).2
American Thoracic Society, Centers for Disease Control and Prevention, Infectious Diseases Society of America (2003). Treatment of tuberculosis. American Journal of Respiratory and Critical Care Medicine, 167(4): 603–662.
Cegielski P, et al. (2012). Challenges and controversies in defining totally drug-resistant tuberculosis. Emerging Infectious Diseases [Internet], November. Available online:
April 4, 2013
E. Gregory Thompson, MD - Internal Medicine & R. Steven Tharratt, MD, MPVM, FACP, FCCP - Pulmonology, Critical Care Medicine, Medical Toxicology
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