Multidrug-resistant tuberculosis not due to noncompliance but to between-patient pharmacokinetic variability.

ABSTRACT:

Background

It is believed that nonadherence is the proximate cause of multidrug-resistant tuberculosis (MDR-tuberculosis) emergence. The level of nonadherence associated with emergence of MDR-tuberculosis is unknown. Performance of a randomized controlled trial in which some patients are randomized to nonadherence would be unethical; therefore, other study designs should be utilized.

Methods

We performed hollow fiber studies for both bactericidal and sterilizing effect, with inoculum spiked with 0.5% rifampin- and isoniazid-resistant isogenic strains in some experiments. Standard therapy was administered daily for 28-56 days, with extents of nonadherence varying between 0% and 100%. Sizes of drug-resistant populations were compared using analysis of variance. We also explore

SUBMITTER: Srivastava S 

PROVIDER: S-EPMC3209814 | biostudies-literature | 2011 Dec

REPOSITORIES: biostudies-literature