Multidrug resistant tuberculosis

Multi-drug resistant tuberculosis (MDRTB) currently receives much media attention. Resistance emerges following inadequate dosing or poor compliance and there have been large outbreaks in the former Soviet Union. Rifampicin resistance can be used as a marker for multiresistance but molecular techniques have disadvantages as methods for detection. Liquid culture based techniques are an improvement on traditional methods. In treatment four drug regimens are advised where the risk of isoniazid resistance exceeds 4% but five or six drug regimens are sometimes needed. Infection control in suspected cases requires the use of negative pressure rooms and respirator masks. An epidemic may have begun but it could take many years for the peak to be seen.