Published 28 August 2008, doi:10.1136/bmj.a1110
Cite this as: BMJ 2008;337:a1110

Clinical Review

Managing drug resistant tuberculosis

Alison Grant, consultant physician, consultant physician 1,2, Philip Gothard, consultant physician1, Guy Thwaites, Wellcome Trust clinician scientist, Wellcome Trust clinician scientist1,3

1 Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London WC1E 6JB, 2 Clinical Research Unit, London School of Hygiene & Tropical Medicine, London WC1E 7HT, 3 Centre for Molecular Microbiology and Infection, Imperial College, London SW7 2AZ

Correspondence to: A Grant alison.grant@lshtm.ac.uk

doi: 10.1136/bmj.a1184

The first 150 words of the full text of this article appear below.


Drug resistant tuberculosis is becoming more common
Traditional laboratory methods for detecting drug resistance are slow and not generally available outside specialist laboratories. Rapid molecular methods are increasingly used in well resourced settings, and simple, cheap alternatives are being developed for resource limited settings
The evidence base to guide drug treatment of resistant tuberculosis is weak, and randomised controlled trials are needed
A service advising on the management of multidrug resistant tuberculosis is available in the United Kingdom
Priorities for prevention of drug resistant tuberculosis include prompt detection of cases, effective treatment of drug sensitive and drug resistant cases, and prevention of tuberculosis transmission


Antituberculosis drug resistance is increasing both in the United Kingdom and internationally.1 2 It has come to greater public attention with the emergence of extensively drug resistant tuberculosis (box 1) in South Africa, where an outbreak proved rapidly fatal among people with advanced HIV infection.3 In this . . . [Full text of this article]

Global risk factors
Additional risk factors in United Kingdom

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